# DIANE O'NEILL LISW LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003177395
- **Authorized official:** DIANE O'NEILL LISW (SOLE MEMBER/MANAGER)
- **Authorized official phone:** (803) 619-9103

## Contact information

- **Practice address:** 852 GOLD HILL RD, SUITE 206, FORT MILL, SC 29708-7976
- **Practice address phone:** (803) 619-9103
- **Practice address fax:** (866) 585-6452
- **Mailing address:** 852 GOLD HILL RD, SUITE 206, FORT MILL, SC 29708-7976
- **Mailing address phone:** (803) 619-9103
- **Mailing address fax:** (866) 585-6452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 9672 | SC | Yes |

## Other

- **Enumeration date:** 06/03/2012
- **Last updated:** 06/03/2012