Provider Demographics
NPI:1649309253
Name:O'NEILL, AMELIA JAYNE (PHD)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:JAYNE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2538
Mailing Address - Country:US
Mailing Address - Phone:910-451-5125
Mailing Address - Fax:910-451-0698
Practice Address - Street 1:1000 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3938
Practice Address - Country:US
Practice Address - Phone:882-860-8400
Practice Address - Fax:910-451-0698
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2209103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0327QOtherBCBS
NC6000425Medicaid
NC187863OtherMEDCOST