Healthcare Provider Details

I. General information

NPI: 1144672601
Provider Name (Legal Business Name): SHAWNEE NEAL LCSW, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAWNEE PALMER

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 AUSTIN BLUFFS PKWY STE 311023
COLORADO SPRINGS CO
80918-6671
US

IV. Provider business mailing address

3609 AUSTIN BLUFFS PKWY STE 311023
COLORADO SPRINGS CO
80918-6671
US

V. Phone/Fax

Practice location:
  • Phone: 314-516-3718
  • Fax: 833-205-9752
Mailing address:
  • Phone: 314-516-3718
  • Fax: 833-205-9752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTLS.1128.CP
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0000746
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.020643
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC016057
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924939
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2017035177
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: