Provider Demographics
NPI:1538033204
Name:NEAL, ANNAMARIE (LSW)
Entity type:Individual
Prefix:
First Name:ANNAMARIE
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 STATE HIGHWAY 96
Mailing Address - Street 2:
Mailing Address - City:OLNEY SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81062-9801
Mailing Address - Country:US
Mailing Address - Phone:719-289-6390
Mailing Address - Fax:
Practice Address - Street 1:208 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-1538
Practice Address - Country:US
Practice Address - Phone:719-363-1512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009925218101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty