Provider Demographics
NPI:1265569065
Name:NEEL, MITZY K (LMHC)
Entity type:Individual
Prefix:MS
First Name:MITZY
Middle Name:K
Last Name:NEEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:MITZY
Other - Middle Name:K NEEL
Other - Last Name:GALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:826 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-4608
Mailing Address - Country:US
Mailing Address - Phone:904-614-5521
Mailing Address - Fax:904-241-7055
Practice Address - Street 1:2380 3RD ST S
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4072
Practice Address - Country:US
Practice Address - Phone:904-614-5521
Practice Address - Fax:904-241-7055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8334101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1041C0700XOtherPROVIDER TAXONOMIES
FL262574034OtherEIN
FLZ0616ZMedicare UPIN