Provider Demographics
NPI:1396450367
Name:NEELY, DANIELLE (MMFT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NEELY
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2491 N MOUNT JULIET RD # 632
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8026
Mailing Address - Country:US
Mailing Address - Phone:629-241-0110
Mailing Address - Fax:
Practice Address - Street 1:4219 HILLSBORO PIKE STE 338
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3332
Practice Address - Country:US
Practice Address - Phone:629-241-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002766106H00000X
TN1976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist