Provider Demographics
NPI:1972678670
Name:O'NEILL, KATHLEEN (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MONTVALE AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2446
Mailing Address - Country:US
Mailing Address - Phone:781-254-1966
Mailing Address - Fax:888-520-7622
Practice Address - Street 1:38 MONTVALE AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2446
Practice Address - Country:US
Practice Address - Phone:781-254-1966
Practice Address - Fax:888-520-7622
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health