Provider Demographics
NPI:1811552938
Name:O'NEAL, MICHELE DENISE
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:DENISE
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 1:648 E 11TH ST APT D3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-4197
Mailing Address - Country:US
Mailing Address - Phone:917-796-5705
Mailing Address - Fax:
Practice Address - Street 1:648 E 11TH ST APT D3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-4197
Practice Address - Country:US
Practice Address - Phone:917-796-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health