Provider Demographics
NPI:1720115512
Name:THE NEIL GROUP, INC
Entity Type:Organization
Organization Name:THE NEIL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANSFORD
Authorized Official - Middle Name:AUTHURBURY
Authorized Official - Last Name:NEIL
Authorized Official - Suffix:II
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:336-774-2194
Mailing Address - Street 1:1399 ASHLEYBROOK LN STE 100
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2961
Mailing Address - Country:US
Mailing Address - Phone:336-774-2194
Mailing Address - Fax:336-774-2195
Practice Address - Street 1:1399 ASHLEYBROOK LN STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2961
Practice Address - Country:US
Practice Address - Phone:336-774-2194
Practice Address - Fax:336-774-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 101YP2500X, 103T00000X, 1041C0700X, 251S00000X
NC4865101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006082Medicaid