Provider Demographics
NPI:1356886238
Name:NEAL, STEPHANIE (LMSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 6TH AVE S
Mailing Address - Street 2:SUITE 25
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4338
Mailing Address - Country:US
Mailing Address - Phone:563-242-9210
Mailing Address - Fax:
Practice Address - Street 1:215 6TH AVE S
Practice Address - Street 2:SUITE 25
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4338
Practice Address - Country:US
Practice Address - Phone:563-242-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA072295104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker