MEDICARE: MAUREEN O'NEIL LICSW

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	1041C0700X	Clinical Social Worker		MA

General Provider Information

NPI Number	:	1629664925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN O'NEIL LICSW

Provider Business Mailing Address
First Line	:	708 FEDERAL ST
Second Line	:
City	:	BELCHERTOWN
State	:	MA
Zip	:	01007-9360
Country	:	US
Telephone Number	:	413-461-5261
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 STATE ST FL 3
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01103-2006
Country	:	US
Telephone Number	:	413-355-5236
Fax Number	:

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

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	12/21/2020

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