Healthcare Provider Details

I. General information

NPI: 1568334324
Provider Name (Legal Business Name): ANGELA S. MCNEIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WASHINGTON LN STE 6A2
WYNCOTE PA
19095-1426
US

IV. Provider business mailing address

12 SPICER PL
LAWNSIDE NJ
08045-1157
US

V. Phone/Fax

Practice location:
  • Phone: 215-800-6589
  • Fax:
Mailing address:
  • Phone: 215-688-5093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: