NPI Code Details Logo

NPI 1861718850

NPI 1861718850 : KIMBERLY EDWARDS NEAL LPC-S, NCC : PHILADELPHIA, MS

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1861718850
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KIMBERLY EDWARDS NEAL LPC-S, NCC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/15/2010
-----------------------------------------------------
    Last Update Date     |    01/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    10021 DOGWOOD LN 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    MS
-----------------------------------------------------
    Zip                  |    39350-9642
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    601-575-2206
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    10021 DOGWOOD LN 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    MS
-----------------------------------------------------
    Zip                  |    39350-9642
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    601-575-2206
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    0663
-----------------------------------------------------
    License Number State |    MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    663
-----------------------------------------------------
    License Number State |    MS
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.