Provider Demographics
NPI:1689253841
Name:O'NEAL, CASEY ELIZABETH
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ELIZABETH
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1658 SUMMER MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2885
Mailing Address - Country:US
Mailing Address - Phone:850-345-2366
Mailing Address - Fax:
Practice Address - Street 1:1658 SUMMER MEADOW PL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-2885
Practice Address - Country:US
Practice Address - Phone:850-345-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW182771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical