Provider Demographics
NPI:1992508915
Name:MCNEAL, AVIS SHERITA (AMFT)
Entity type:Individual
Prefix:MRS
First Name:AVIS
Middle Name:SHERITA
Last Name:MCNEAL
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73726 ALESSANDRO DR STE 203
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3640
Mailing Address - Country:US
Mailing Address - Phone:205-704-7868
Mailing Address - Fax:
Practice Address - Street 1:73726 ALESSANDRO DR STE 203
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3640
Practice Address - Country:US
Practice Address - Phone:205-704-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT152896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist