Provider Demographics
NPI:1467042432
Name:O'NEIL, TARYN (LCPC)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N DAMEN AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6709
Mailing Address - Country:US
Mailing Address - Phone:708-870-6185
Mailing Address - Fax:
Practice Address - Street 1:661 W LAKE ST STE 2S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-1034
Practice Address - Country:US
Practice Address - Phone:708-870-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016287101YM0800X
IL180.015353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health