Provider Demographics
NPI:1992055727
Name:LABRANCHE-O'NEAL, ANIETRA P (PSY D)
Entity type:Individual
Prefix:DR
First Name:ANIETRA
Middle Name:P
Last Name:LABRANCHE-O'NEAL
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 LINCOLN HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1862
Mailing Address - Country:US
Mailing Address - Phone:773-364-6143
Mailing Address - Fax:
Practice Address - Street 1:7600 S PARNELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1824
Practice Address - Country:US
Practice Address - Phone:773-783-0500
Practice Address - Fax:773-783-0600
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178003532101YP2500X
101YM0800X, 106H00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent