Provider Demographics
NPI:1992466015
Name:NEIL, ANTOINETTE P (AADP,CIMHP,CHC)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:P
Last Name:NEIL
Suffix:
Gender:F
Credentials:AADP,CIMHP,CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5701
Mailing Address - Country:US
Mailing Address - Phone:615-459-2920
Mailing Address - Fax:
Practice Address - Street 1:41A W MERRICK RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5708
Practice Address - Country:US
Practice Address - Phone:516-459-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY52813008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health