Provider Demographics
NPI:1891927281
Name:O'NEALL, ANDREW EVAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EVAN
Last Name:O'NEALL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 OLIVE HILL LN
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2109
Mailing Address - Country:US
Mailing Address - Phone:317-847-3413
Mailing Address - Fax:
Practice Address - Street 1:709 S 18TH ST STE C
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-1572
Practice Address - Country:US
Practice Address - Phone:765-709-0500
Practice Address - Fax:765-709-9720
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24838103T00000X
IN20042358A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist