Provider Demographics
NPI:1669636163
Name:MCNEIL, JEFFREY J (LADC-1)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:LADC-1
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 1011
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02541-1011
Mailing Address - Country:US
Mailing Address - Phone:508-221-2217
Mailing Address - Fax:
Practice Address - Street 1:197 PALMER AVE UNIT 246
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2806
Practice Address - Country:US
Practice Address - Phone:508-221-2217
Practice Address - Fax:508-221-2217
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)