Provider Demographics
NPI:1780741694
Name:O'NEILL, JAINE B SR (LCSW)
Entity type:Individual
Prefix:MS
First Name:JAINE
Middle Name:B
Last Name:O'NEILL
Suffix:SR
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 E 75TH ST
Mailing Address - Street 2:#5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3314
Mailing Address - Country:US
Mailing Address - Phone:212-744-3364
Mailing Address - Fax:212-744-3364
Practice Address - Street 1:310 E 75TH ST
Practice Address - Street 2:#5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3314
Practice Address - Country:US
Practice Address - Phone:212-744-3364
Practice Address - Fax:212-744-3364
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041814-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical