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General NPI Number Information
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NPI Number | 1215359633
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Entity Type | Individual
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Provider Name | STACIA NEALS LPC
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Gender | Female
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 151 CENTENNIAL AVE
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3907
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Country | US
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Telephone | 732-580-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 42 LARKSPUR DR
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City | DAYTON
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State | NJ
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Zip | 08810-1450
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Country | US
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Telephone | 732-485-6447
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37AC00105200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC00552600
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License Number State | NJ
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