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Individual

KEISHA MCNEILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
122 GORDON COMMERCIAL DR STE C, LAGRANGE, GA 30240-5754
(706) 845-4045
Mailing address
8129 CARLTON RD, RIVERDALE, GA 30296-1210
(706) 955-6134

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC014644
GA
101YM0800X
Mental Health Counselor
GA
106S00000X
Behavior Technician
RBT-18-64081
GA

Other

Enumeration date
07/07/2021
Last updated
07/02/2025
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