Provider Demographics
NPI:1851793525
Name:MCNEALY, MICHELLE LEVONIA (LMHC MH19584)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEVONIA
Last Name:MCNEALY
Suffix:
Gender:F
Credentials:LMHC MH19584
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4436
Mailing Address - Country:US
Mailing Address - Phone:850-782-2283
Mailing Address - Fax:
Practice Address - Street 1:1804 SKYLAND DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4436
Practice Address - Country:US
Practice Address - Phone:850-782-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLM254552698290OtherDRIVER LISCENSE
FLM254552698290OtherDRIVER LISCENSE