Provider Demographics
NPI:1053489427
Name:O'NEILL, JOANNA (MA LPC NCC DCC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MA LPC NCC DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 SODEN DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-2941
Mailing Address - Country:US
Mailing Address - Phone:609-585-7822
Mailing Address - Fax:609-890-2445
Practice Address - Street 1:2275 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE #9
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2643
Practice Address - Country:US
Practice Address - Phone:609-585-7822
Practice Address - Fax:609-890-2445
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00017900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ593055000Medicare UPIN
NJ2081101Medicare UPIN
NJN14660574Medicare UPIN