Provider Demographics
NPI:1104230614
Name:MCNEAL, KRISTI R (LSCSW)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:R
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:KS
Mailing Address - Zip Code:67144-0245
Mailing Address - Country:US
Mailing Address - Phone:316-371-7130
Mailing Address - Fax:
Practice Address - Street 1:3310 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3314
Practice Address - Country:US
Practice Address - Phone:316-272-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8461104100000X
KS4727104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker