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General NPI Number Information
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NPI Number | 1982815403
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Entity Type | Individual
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Provider Name | TIMOTHY LAWRENCE MCNEIL LMHC
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Gender | Male
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 336 S HALIFAX DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-8111
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Country | US
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Telephone | 386-677-5376
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Fax | 386-673-5347
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Provider Business Mailing Address
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Address Line | 6 HANOVER DR
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-4932
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Country | US
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Telephone | 386-439-6231
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | MH3217
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License Number State | FL
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