Provider Demographics
NPI:1205557279
Name:NEAL, CAROLINE OLIVIA (MA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:OLIVIA
Last Name:NEAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:OLIVIA BRYANT
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:416 S WHEATON AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5397
Mailing Address - Country:US
Mailing Address - Phone:816-215-1262
Mailing Address - Fax:
Practice Address - Street 1:2172 BLACKBERRY DR STE 202
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1106
Practice Address - Country:US
Practice Address - Phone:630-793-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist