Provider Demographics
NPI:1487949194
Name:NEECE, JONATHON (MS, LPC-S)
Entity type:Individual
Prefix:MR
First Name:JONATHON
Middle Name:
Last Name:NEECE
Suffix:
Gender:M
Credentials:MS, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 533
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5332
Mailing Address - Country:US
Mailing Address - Phone:972-379-7602
Mailing Address - Fax:866-410-7457
Practice Address - Street 1:10300 N CENTRAL EXPY
Practice Address - Street 2:SUITE 335
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8600
Practice Address - Country:US
Practice Address - Phone:972-379-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288459501Medicaid