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General NPI Number Information
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NPI Number | 1962173765
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Entity Type | Organization
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Legal Business Name | MELISSA O'NEILL, PA
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 2598 E SUNRISE BLVD STE 2104
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3230
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Country | US
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Telephone | 954-408-2602
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 N OCEAN BLVD APT 325
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City | FORT LAUDERDALE
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State | FL
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Zip | 33305-1965
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Country | US
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Telephone | 954-955-8084
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. MELISSA SUE O'NEILL
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Credential | LMHC
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Telephone | 954-408-2602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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