Provider Demographics
NPI:1336536564
Name:NEFF, MICHAL ALLEN (LCSW, CSUDC)
Entity Type:Individual
Prefix:MR
First Name:MICHAL
Middle Name:ALLEN
Last Name:NEFF
Suffix:
Gender:M
Credentials:LCSW, CSUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 861
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84029-0861
Mailing Address - Country:US
Mailing Address - Phone:435-200-3107
Mailing Address - Fax:435-291-3201
Practice Address - Street 1:352 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-1657
Practice Address - Country:US
Practice Address - Phone:435-200-3107
Practice Address - Fax:435-291-3201
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8051913-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical