Healthcare Provider Details

I. General information

NPI: 1508720699
Provider Name (Legal Business Name): TAMICKA LASHAWN NEAL MA,LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6416 LARSON CT
KANSAS CITY MO
64133-7505
US

IV. Provider business mailing address

PO BOX 16864
RAYTOWN MO
64133-0964
US

V. Phone/Fax

Practice location:
  • Phone: 816-337-1717
  • Fax:
Mailing address:
  • Phone: 816-337-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2021015200
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC04260
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: