Healthcare Provider Details

I. General information

NPI: 1407032436
Provider Name (Legal Business Name): KIMBERLY SUZANNE NEAL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 HOLLY TER APT 9
DALTON GA
30720-4359
US

IV. Provider business mailing address

2125 HOLLY TER APT 9
DALTON GA
30720-4359
US

V. Phone/Fax

Practice location:
  • Phone: 407-448-8195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC016620
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH10517
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23211
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: