Provider Demographics
NPI:1912642463
Name:NEELEY, TAYLOR GARRETT (LCSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:GARRETT
Last Name:NEELEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ADELAIDE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:517 W GRACE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4911
Mailing Address - Country:US
Mailing Address - Phone:804-783-2505
Mailing Address - Fax:
Practice Address - Street 1:517 W GRACE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4911
Practice Address - Country:US
Practice Address - Phone:804-783-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040139431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical