Provider Demographics
NPI:1245440122
Name:O'NEILL, KEVIN (LCSW, LCADC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-1636
Mailing Address - Country:US
Mailing Address - Phone:609-610-6051
Mailing Address - Fax:973-232-4725
Practice Address - Street 1:5 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1636
Practice Address - Country:US
Practice Address - Phone:609-259-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002984001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical