Provider Demographics
NPI:1326382557
Name:DORNELL-NEAL, LAUREN ELIZABETH (LCMHC, LCAS, DOULA)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:DORNELL-NEAL
Suffix:
Gender:
Credentials:LCMHC, LCAS, DOULA
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LCAS
Mailing Address - Street 1:521 YOPP RD STE 214-308
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3595
Mailing Address - Country:US
Mailing Address - Phone:980-355-2260
Mailing Address - Fax:833-837-7903
Practice Address - Street 1:521 YOPP RD STE 214-308
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3595
Practice Address - Country:US
Practice Address - Phone:980-355-2260
Practice Address - Fax:833-837-7903
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-10
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
NCLCAS-2834101YA0400X
NC9301101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1326382557Medicaid