Provider Demographics
NPI:1396501342
Name:MCNEELY, AMY CHRISTINE (LCDC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINE
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 S US HIGHWAY 83
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-5437
Mailing Address - Country:US
Mailing Address - Phone:325-642-4514
Mailing Address - Fax:
Practice Address - Street 1:539 S US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-5437
Practice Address - Country:US
Practice Address - Phone:325-642-4514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11282101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)