Provider Demographics
NPI:1881996783
Name:NEAL, VICKI L (LISW-S)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:L
Last Name:NEAL
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 BYCROFT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3307
Mailing Address - Country:US
Mailing Address - Phone:614-271-3101
Mailing Address - Fax:
Practice Address - Street 1:1070 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2374
Practice Address - Country:US
Practice Address - Phone:614-231-1890
Practice Address - Fax:614-231-4978
Is Sole Proprietor?:No
Enumeration Date:2010-11-28
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0007572 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical