Provider Demographics
NPI:1922147859
Name:MCNEIL, DEENA (MS, NCC)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:DEENA
Other - Middle Name:
Other - Last Name:CORSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:1401 NE 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4957
Mailing Address - Country:US
Mailing Address - Phone:503-988-4067
Mailing Address - Fax:503-988-4664
Practice Address - Street 1:1401 NE 68TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4957
Practice Address - Country:US
Practice Address - Phone:503-988-4067
Practice Address - Fax:503-988-4664
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR0514101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor