Healthcare Provider Details

I. General information

NPI: 1891879599
Provider Name (Legal Business Name): MARILYN S NEEL LCSW, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8149 NEW LAGRANGE RD SUITE 101
LOUISVILLE KY
40222-4689
US

IV. Provider business mailing address

8149 NEW LAGRANGE RD SUITE 101
LOUISVILLE KY
40222-4689
US

V. Phone/Fax

Practice location:
  • Phone: 502-412-6444
  • Fax: 502-412-6444
Mailing address:
  • Phone: 502-412-6444
  • Fax: 502-412-6444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number529
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number208
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: