Provider Demographics
NPI:1851303697
Name:O'NEAL, JAMES BRADLEY (MS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRADLEY
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W 8TH ST
Mailing Address - Street 2:P.O. BOX 681
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-1443
Mailing Address - Country:US
Mailing Address - Phone:618-263-3322
Mailing Address - Fax:
Practice Address - Street 1:114 W 8TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-1443
Practice Address - Country:US
Practice Address - Phone:618-263-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker