Provider Demographics
NPI:1538399811
Name:NEAL, MELVIN ANTHONY (LPC)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:ANTHONY
Last Name:NEAL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MAYMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-3662
Mailing Address - Country:US
Mailing Address - Phone:919-596-2046
Mailing Address - Fax:
Practice Address - Street 1:2314 S MIAMI BLVD STE 154
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5796
Practice Address - Country:US
Practice Address - Phone:919-381-5703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7435101YP2500X
NJ37PC00386200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional