Healthcare Provider Details

I. General information

NPI: 1619800588
Provider Name (Legal Business Name): KERRY ONEIL, LMFT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MAIN ST
CANAAN CT
06018-2463
US

IV. Provider business mailing address

18 SHARON TPKE
GOSHEN CT
06756-1501
US

V. Phone/Fax

Practice location:
  • Phone: 860-309-4422
  • Fax:
Mailing address:
  • Phone: 860-309-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KERRY ELIZABETH O'NEIL
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: LMFT
Phone: 860-309-4422