MEDICARE: KAYLEIGH ANN MCNEILL LCSW

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	1041C0700X	Clinical Social Worker	0904017035	VA

General Provider Information

NPI Number	:	1891646030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEIGH ANN MCNEILL LCSW

Provider Business Mailing Address
First Line	:	315 BOWMAN AVE
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-6227
Country	:	US
Telephone Number	:	801-678-9612
Fax Number	:

Provider Business Practice Location Address
First Line	:	4434 ELECTRIC RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0722
Country	:	US
Telephone Number	:	540-527-4900
Fax Number	:

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

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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