Provider Demographics
NPI:1083969646
Name:O'NEILL, DEIRDRE L (LPC)
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:L
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEE
Other - Middle Name:
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:502 HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-3153
Mailing Address - Country:US
Mailing Address - Phone:972-638-7689
Mailing Address - Fax:
Practice Address - Street 1:502 HARBOR DR
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-3153
Practice Address - Country:US
Practice Address - Phone:972-638-7689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64182101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional