Provider Demographics
NPI:1780293308
Name:ONEILL, MARICELI (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARICELI
Middle Name:
Last Name:ONEILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARICELI
Other - Middle Name:
Other - Last Name:VELAZQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:6688 ARLENE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-9376
Mailing Address - Country:US
Mailing Address - Phone:561-900-5811
Mailing Address - Fax:
Practice Address - Street 1:6688 ARLENE DR
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-9376
Practice Address - Country:US
Practice Address - Phone:561-900-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
MI6351004396103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health