Provider Demographics
NPI:1265535207
Name:NEER, PHYLLIS J (PHD, LPC, ALPS)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:J
Last Name:NEER
Suffix:
Gender:F
Credentials:PHD, LPC, ALPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-1184
Mailing Address - Country:US
Mailing Address - Phone:304-265-0400
Mailing Address - Fax:304-265-6419
Practice Address - Street 1:500 MARKET ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-1184
Practice Address - Country:US
Practice Address - Phone:304-265-0400
Practice Address - Fax:304-265-6419
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV952103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA001722043OtherBCBS