Provider Demographics
NPI:1689118200
Name:O'NEILL, ADAM (LPCC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3912
Mailing Address - Country:US
Mailing Address - Phone:651-457-2248
Mailing Address - Fax:
Practice Address - Street 1:130 WABASHA ST S
Practice Address - Street 2:SUITE 90
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1819
Practice Address - Country:US
Practice Address - Phone:651-291-0067
Practice Address - Fax:651-450-2221
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health