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NPI Code Detail

MEDICARE: MATTHEW DANIEL O'NEAL B.A.

MEDICARE: MATTHEW DANIEL O'NEAL B.A.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1396088159
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DANIEL O'NEAL B.A.
Provider Business Mailing Address
First Line : 318 HOWELL ST
Second Line :
City : GOLDEN
State : CO
Zip : 80401-5123
Country : US
Telephone Number : 303-249-0532
Fax Number :
Provider Business Practice Location Address
First Line : 7595 KRAMERIA ST
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1339
Country : US
Telephone Number : 303-287-7270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2013
Last Update Date : 03/30/2013

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