Provider Demographics
NPI:1649290743
Name:O'NEAL, VAUGHN P (LCSW)
Entity type:Individual
Prefix:MR
First Name:VAUGHN
Middle Name:P
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11807 WESTHEIMER RD
Mailing Address - Street 2:STE 550 PMB 736
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077
Mailing Address - Country:US
Mailing Address - Phone:832-539-3892
Mailing Address - Fax:
Practice Address - Street 1:11807 WESTHEIMER RD
Practice Address - Street 2:STE 550 PMB 736
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077
Practice Address - Country:US
Practice Address - Phone:832-539-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117709904Medicaid
TX117709904Medicaid