Provider Demographics
NPI:1316196868
Name:O'NEIL, MARIE T (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:T
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 CANAL ST STE 404
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5874
Mailing Address - Country:US
Mailing Address - Phone:504-444-4344
Mailing Address - Fax:
Practice Address - Street 1:4902 CANAL ST STE 404
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5874
Practice Address - Country:US
Practice Address - Phone:504-444-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA99571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1811718Medicaid
LA1811718Medicaid