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General NPI Number Information
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NPI Number | 1972145910
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Entity Type | Individual
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Provider Name | CAITLIN O'NEILL LLPC
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 279 SUMMIT DR
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City | WATERFORD
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State | MI
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Zip | 48328-3364
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Country | US
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Telephone | 248-745-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 536 BURGESS DR
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City | WHITE LAKE
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State | MI
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Zip | 48386-2816
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Country | US
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Telephone | 248-672-1142
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401017762
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License Number State | MI
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