Provider Demographics
NPI:1366565020
Name:O'NEAL, BARBARA AMM (MS LCPC)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:AMM
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:MS LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14430 TWIN GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-5184
Mailing Address - Country:US
Mailing Address - Phone:309-963-5600
Mailing Address - Fax:309-963-4152
Practice Address - Street 1:14430 TWIN GROVE RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-5184
Practice Address - Country:US
Practice Address - Phone:309-963-5600
Practice Address - Fax:309-963-4152
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health