Provider Demographics
NPI:1073850335
Name:O'NEILL, JOLYCE ADELE (LCPC)
Entity Type:Individual
Prefix:
First Name:JOLYCE
Middle Name:ADELE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10005 OLD COLUMBIA RD
Mailing Address - Street 2:SUITE L260
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1702
Mailing Address - Country:US
Mailing Address - Phone:443-259-0400
Mailing Address - Fax:443-259-0044
Practice Address - Street 1:10005 OLD COLUMBIA RD
Practice Address - Street 2:SUITE L260
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1702
Practice Address - Country:US
Practice Address - Phone:443-259-0400
Practice Address - Fax:443-259-0044
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional