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General NPI Number Information
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NPI Number | 1366108292
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Entity Type | Organization
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Legal Business Name | JOHN O'NEILL, LICSW, PLLC
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 7 S HOWARD ST STE 428
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City | SPOKANE
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State | WA
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Zip | 99201-3816
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Country | US
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Telephone | 509-993-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 2416 S MONROE ST
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City | SPOKANE
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State | WA
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Zip | 99203-1271
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Country | US
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Telephone | 509-993-3555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN O'NEILL
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Credential | LICSW
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Telephone | 509-993-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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