Provider Demographics
NPI:1679726780
Name:O'NEIL, JOYCE CODY (MA, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:CODY
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4346
Mailing Address - Country:US
Mailing Address - Phone:802-242-1499
Mailing Address - Fax:802-857-0176
Practice Address - Street 1:34 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4346
Practice Address - Country:US
Practice Address - Phone:802-242-1499
Practice Address - Fax:802-857-0176
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1015713Medicaid