Individual
MICHAEL O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
(401) 383-5811
(401) 383-5822
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
(401) 383-5811
(401) 383-5822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00576
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104847946
—
RI
Enumeration date
05/20/2014
Last updated
05/21/2014
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