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General NPI Number Information
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NPI Number | 1144317843
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Entity Type | Individual
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Provider Name | MARTHA CECELIA NEELY L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 64 CHESTER ST
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City | FRONT ROYAL
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State | VA
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Zip | 22630-3367
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Country | US
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Telephone | 540-635-6119
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Fax | 540-635-6140
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Provider Business Mailing Address
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Address Line | 532 EAGLE PL
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City | WINCHESTER
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State | VA
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Zip | 22601-5105
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Country | US
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Telephone | 540-722-0560
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Fax | 540-722-0560
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904001107
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License Number State | VA
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