Provider Demographics
NPI:1982815403
Name:MCNEIL, TIMOTHY LAWRENCE (LMHC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:LAWRENCE
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HANOVER DR
Mailing Address - Street 2:
Mailing Address - City:FLAGLER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32136-4932
Mailing Address - Country:US
Mailing Address - Phone:386-439-6231
Mailing Address - Fax:
Practice Address - Street 1:336 S HALIFAX DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-8111
Practice Address - Country:US
Practice Address - Phone:386-677-5376
Practice Address - Fax:386-673-5347
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3217101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH3217OtherSTATE LICENSE NUMBER