Provider Demographics
NPI:1659653905
Name:O'NEILL, JESSICA TIANSHING (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:TIANSHING
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:T
Other - Last Name:FRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:8362 SIX FORKS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5086
Mailing Address - Country:US
Mailing Address - Phone:207-385-3685
Mailing Address - Fax:984-202-2222
Practice Address - Street 1:8362 SIX FORKS RD STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5086
Practice Address - Country:US
Practice Address - Phone:207-385-3685
Practice Address - Fax:984-202-2222
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095881041C0700X, 104100000X, 1041C0700X
MA218370104100000X
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker