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General NPI Number Information
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NPI Number | 1457167769
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Entity Type | Individual
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Provider Name | JOHN CALVIN O'NEIL JR. LCSW, LADC
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Gender | Male
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 86 CHERRY ST FL 2
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City | MILFORD
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State | CT
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Zip | 06460-3413
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Country | US
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Telephone | 203-249-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 86 CHERRY ST FL 2
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City | MILFORD
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State | CT
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Zip | 06460-3413
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Country | US
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Telephone | 203-249-7837
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0136543TELE
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 001419
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 012916
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License Number State | CT
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