Provider Demographics
NPI:1548782634
Name:O'NEIL, CHELSEA (MA, LPC-IT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MA, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 HILLDALE CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2613
Mailing Address - Country:US
Mailing Address - Phone:608-301-6167
Mailing Address - Fax:
Practice Address - Street 1:6314 ODANA RD STE E
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1194
Practice Address - Country:US
Practice Address - Phone:608-571-2613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3572226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty