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NPI Code Detail

MEDICARE: REBECCA O'NEILL LCSW

MEDICARE: REBECCA O'NEILL 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 Worker0904012655VA

General Provider Information

NPI Number : 1386239200
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA O'NEILL LCSW
Provider Business Mailing Address
First Line : 18622 BERWYN CT
Second Line :
City : LEESBURG
State : VA
Zip : 20176-5150
Country : US
Telephone Number : 703-786-4935
Fax Number :
Provider Business Practice Location Address
First Line : 11150 SUNSET HILLS RD STE 150
Second Line :
City : RESTON
State : VA
Zip : 20190-5325
Country : US
Telephone Number : 703-786-4935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2021
Last Update Date : 03/02/2021

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