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NPI Code Detail

MEDICARE: MRS. LAURA JEANNE O'NEAL LCSW

MEDICARE: MRS. LAURA JEANNE O'NEAL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker09040006905VA

General Provider Information

NPI Number : 1033414941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA JEANNE O'NEAL LCSW
Provider Business Mailing Address
First Line : 2200 COLONIAL AVE STE 12
Second Line :
City : NORFOLK
State : VA
Zip : 23517-1919
Country : US
Telephone Number : 757-646-5195
Fax Number :
Provider Business Practice Location Address
First Line : 2200 COLONIAL AVE STE 12
Second Line :
City : NORFOLK
State : VA
Zip : 23517-1919
Country : US
Telephone Number : 757-646-5195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2011
Last Update Date : 12/06/2025

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