Provider Demographics
NPI:1407044316
Name:O'NEILL, SHANNON MICHELE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:MICHELE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 1/2 MONTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1060
Mailing Address - Country:US
Mailing Address - Phone:828-713-5875
Mailing Address - Fax:828-255-5858
Practice Address - Street 1:25 ORANGE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2328
Practice Address - Country:US
Practice Address - Phone:828-713-5875
Practice Address - Fax:828-255-5858
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional