Healthcare Provider Details

I. General information

NPI: 1972389922
Provider Name (Legal Business Name): AUDREY O'NEILL MS, PMHNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DERBY STREET SUITE 206
HINGHAM MA
02043-3786
US

IV. Provider business mailing address

1 DERBY STREET SUITE 206
HINGHAM MA
02043-3786
US

V. Phone/Fax

Practice location:
  • Phone: 781-236-3081
  • Fax: 857-290-4470
Mailing address:
  • Phone: 781-236-3081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2371482
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2371482
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: