Provider Demographics
NPI:1184041188
Name:O'NEILL, KATY MCESSY (LICSW)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:MCESSY
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MCESSY
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5801 SOUNDVIEW DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-2095
Mailing Address - Country:US
Mailing Address - Phone:253-861-9811
Mailing Address - Fax:253-851-6178
Practice Address - Street 1:5801 SOUNDVIEW DR
Practice Address - Street 2:SUITE 255
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2095
Practice Address - Country:US
Practice Address - Phone:253-851-6178
Practice Address - Fax:253-851-6199
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 000080441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical