Provider Demographics
NPI:1720788391
Name:NEECK, JAMES BERNARD (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BERNARD
Last Name:NEECK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 SW 9TH PL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5516
Mailing Address - Country:US
Mailing Address - Phone:954-218-1117
Mailing Address - Fax:
Practice Address - Street 1:12711 SW 9TH PL
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-5516
Practice Address - Country:US
Practice Address - Phone:954-218-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL167351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty