Provider Demographics
NPI:1457670093
Name:ONEAL, ANGE MARY
Entity Type:Individual
Prefix:MS
First Name:ANGE
Middle Name:MARY
Last Name:ONEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CARRIAGE LN
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6065
Mailing Address - Country:US
Mailing Address - Phone:843-573-1905
Mailing Address - Fax:843-573-1926
Practice Address - Street 1:4 CARRIAGE LN
Practice Address - Street 2:SUITE 302
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6065
Practice Address - Country:US
Practice Address - Phone:843-573-1905
Practice Address - Fax:843-573-1926
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX7721Medicaid