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General NPI Number Information
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NPI Number | 1851763205
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Entity Type | Organization
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Legal Business Name | STACY MCNEELY LMSW PLC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 36 W 8TH ST SUITE 250
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City | HOLLAND
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State | MI
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Zip | 49423-2701
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Country | US
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Telephone | 616-805-8341
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Fax | 616-258-2200
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Provider Business Mailing Address
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Address Line | 425 LAKESHORE DR S
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City | HOLLAND
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State | MI
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Zip | 49424-2222
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Country | US
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Telephone | 616-805-8341
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Fax | 616-258-2200
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Authorized Official
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Title or Position | OWNER
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Name | STACY RENAE MCNEELY
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Credential | MSW, LMSW, ACSW
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Telephone | 616-805-8341
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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 | 6801088465
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License Number State | MI
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