Provider Demographics
NPI:1477958502
Name:O'NEILL, LINDA W (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:W
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 S LAKE DR STE B
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-3701
Mailing Address - Country:US
Mailing Address - Phone:803-785-6618
Mailing Address - Fax:
Practice Address - Street 1:1070 S LAKE DR STE B
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-3701
Practice Address - Country:US
Practice Address - Phone:803-785-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2284104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker