Provider Demographics
NPI:1336338904
Name:ONEILL, JOHN JOSEPH III (EDD, LCSW, LCDC, CAS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:ONEILL
Suffix:III
Gender:M
Credentials:EDD, LCSW, LCDC, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 WHIPPLE WAY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2077
Mailing Address - Country:US
Mailing Address - Phone:832-274-4651
Mailing Address - Fax:
Practice Address - Street 1:6108 WHIPPLE WAY
Practice Address - Street 2:SUITE 450
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2077
Practice Address - Country:US
Practice Address - Phone:832-274-4651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7934101YA0400X
TX308241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)