Provider Demographics
NPI:1992823454
Name:O'NEILL, SANDRA (LCPC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 ADMIRAL COCHRANE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7316
Mailing Address - Country:US
Mailing Address - Phone:410-570-0888
Mailing Address - Fax:
Practice Address - Street 1:175 ADMIRAL COCHRANE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7316
Practice Address - Country:US
Practice Address - Phone:410-570-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional