Provider Demographics
NPI:1578054789
Name:O'NEIL, JON-ERIK
Entity Type:Individual
Prefix:
First Name:JON-ERIK
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WASHINGTON ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4768
Mailing Address - Country:US
Mailing Address - Phone:781-843-3683
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST STE 303
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4768
Practice Address - Country:US
Practice Address - Phone:781-843-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor