Provider Demographics
NPI:1891572921
Name:O'NEIL, ELEANOR ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ELIZABETH
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:ELIZABETH
Other - Last Name:NWANOKWALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:2040 WOODWINDS DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2522
Mailing Address - Country:US
Mailing Address - Phone:651-259-9750
Mailing Address - Fax:
Practice Address - Street 1:2040 WOODWINDS DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2522
Practice Address - Country:US
Practice Address - Phone:651-259-9750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN250131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical