Provider Demographics
NPI:1265008643
Name:ONEILL, ALICE LOVELESS (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:LOVELESS
Last Name:ONEILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:LOVELESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1100 MARKET ST UNIT 2026
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1260
Mailing Address - Country:US
Mailing Address - Phone:703-508-9782
Mailing Address - Fax:
Practice Address - Street 1:455 PENNSYLVANIA AVE STE 105
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3404
Practice Address - Country:US
Practice Address - Phone:215-793-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0210921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical