Provider Demographics
NPI:1922490135
Name:ESTES, EILEEN O'NEILL (PHD, , LPAT, ATR-BC)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:O'NEILL
Last Name:ESTES
Suffix:
Gender:F
Credentials:PHD, , LPAT, ATR-BC
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:MARIE
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1312 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9063
Mailing Address - Country:US
Mailing Address - Phone:502-762-5370
Mailing Address - Fax:
Practice Address - Street 1:1312 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9063
Practice Address - Country:US
Practice Address - Phone:502-762-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0049221700000X
KY167748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist