MEDICARE: EMILY NEELY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E.1700141-SUPV	OH

General Provider Information

NPI Number	:	1346785623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY NEELY

Provider Business Mailing Address
First Line	:	1024 CHEYENNE AVE
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45503-6109
Country	:	US
Telephone Number	:	937-408-7912
Fax Number	:

Provider Business Practice Location Address
First Line	:	1024 CHEYENNE AVE
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45503-6109
Country	:	US
Telephone Number	:	937-408-7912
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2016
Last Update Date	:	03/06/2026

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Directions to “ EMILY NEELY ” Practice Location

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