Healthcare Provider Details

I. General information

NPI: 1538982749
Provider Name (Legal Business Name): SYDNI NEAL COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 E EMPIRE ST STE 114
BLOOMINGTON IL
61704-3630
US

IV. Provider business mailing address

2404 E EMPIRE ST STE 114
BLOOMINGTON IL
61704-3630
US

V. Phone/Fax

Practice location:
  • Phone: 224-300-6747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYDNI NEAL
Title or Position: OWNER
Credential: LCPC
Phone: 217-474-7907