Provider Demographics
NPI:1427101971
Name:DAN MCNEILL, PHD, LLC
Entity type:Organization
Organization Name:DAN MCNEILL, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-771-3790
Mailing Address - Street 1:800 DENOW RD STE C-284
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5246
Mailing Address - Country:US
Mailing Address - Phone:609-771-3790
Mailing Address - Fax:
Practice Address - Street 1:1203 RUSTIC CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2500
Practice Address - Country:US
Practice Address - Phone:609-771-3790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100349600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMC960066Medicare ID - Type UnspecifiedMEDICARE