MEDICARE: MELISSA SUE O'NEILL LMHC

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
1	101YM0800X	Mental Health Counselor	15224	FL
2	101YM0800X	Mental Health Counselor	MH16396	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457868770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA SUE O'NEILL LMHC

Provider Business Mailing Address
First Line	:	2409 N OCEAN BLVD APT 325
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-1965
Country	:	US
Telephone Number	:	954-955-8084
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 N OCEAN BLVD APT 325
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-1965
Country	:	US
Telephone Number	:	954-955-8084
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	09/22/2021

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