Provider Demographics
NPI:1306921275
Name:JOHN N. O'NEIL, PH.D., L.P., LLC
Entity type:Organization
Organization Name:JOHN N. O'NEIL, PH.D., L.P., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:NOLEN
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-455-6167
Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:1735 MEDICAL ARTS BUILDING
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2704
Mailing Address - Country:US
Mailing Address - Phone:612-455-6167
Mailing Address - Fax:612-333-6740
Practice Address - Street 1:825 NICOLLET MALL
Practice Address - Street 2:1735 MEDICAL ARTS BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2704
Practice Address - Country:US
Practice Address - Phone:612-455-6167
Practice Address - Fax:612-333-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4307103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN169041OtherUCARE
6169449OtherMEDICA
MN013764200Medicaid
MN49F69ONOtherBLUE CROSS BLUE SHIELD
MNHP40630OtherHEALTH PARTNERS
MN013764200Medicaid