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General NPI Number Information
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NPI Number | 1407210222
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Entity Type | Individual
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Provider Name | ANDREW BRYAN NEAL LPC
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Gender | Male
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 07/08/2018
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Provider Practice Location Address
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Address Line | 8700 US HIGHWAY 380 STE 519
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City | CROSSROADS
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State | TX
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Zip | 76227
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Country | US
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Telephone | 940-365-9055
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Fax |
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Provider Business Mailing Address
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Address Line | 8537 DUKE TER APT 9303
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City | FORT WORTH
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State | TX
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Zip | 76244-1728
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Country | US
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Telephone | 817-583-3981
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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 | 72433
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License Number State | TX
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