Provider Demographics
NPI:1942726922
Name:NEELEY, CODY ALLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:ALLEN
Last Name:NEELEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 N WALLEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2558
Mailing Address - Country:US
Mailing Address - Phone:850-661-9946
Mailing Address - Fax:
Practice Address - Street 1:13211 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2222
Practice Address - Country:US
Practice Address - Phone:561-337-3200
Practice Address - Fax:561-337-3200
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL136021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical