Provider Demographics
NPI:1649616541
Name:MCNEAL COUNSELING
Entity type:Organization
Organization Name:MCNEAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCNEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-289-8165
Mailing Address - Street 1:975 N MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-7064
Mailing Address - Country:US
Mailing Address - Phone:815-289-8165
Mailing Address - Fax:
Practice Address - Street 1:975 N MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-7064
Practice Address - Country:US
Practice Address - Phone:815-289-8165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490148831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty