MEDICARE: CAREY MCNEILLY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2022019200	MO

General Provider Information

NPI Number	:	1124858113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAREY MCNEILLY LPC

Provider Business Mailing Address
First Line	:	7346 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-3108
Country	:	US
Telephone Number	:	314-833-9793
Fax Number	:

Provider Business Practice Location Address
First Line	:	7346 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-3108
Country	:	US
Telephone Number	:	314-833-9793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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Directions to “ CAREY MCNEILLY LPC” Practice Location

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