Provider Demographics
NPI:1104918051
Name:NEAL, JAYE LOWENTHAL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAYE
Middle Name:LOWENTHAL
Last Name:NEAL
Suffix:
Gender:F
Credentials:LCSW
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Other - First Name:
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Mailing Address - Street 1:2365 HARRODSBURG RD
Mailing Address - Street 2:SUITE B225
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3335
Mailing Address - Country:US
Mailing Address - Phone:859-276-0700
Mailing Address - Fax:859-276-0707
Practice Address - Street 1:2365 HARRODSBURG RD
Practice Address - Street 2:SUITE B225
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3335
Practice Address - Country:US
Practice Address - Phone:859-276-0700
Practice Address - Fax:859-276-0707
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY13561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY30615058Medicaid
KY0978801Medicare PIN
KY0575115Medicare ID - Type UnspecifiedMEDICARE