| Organization Name: | DIANE O'NEILL LISW LLC |
| NPI Number: | 1003177395 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE O'NEILL (SOLE MEMBER/MANAGER) |
| Mailing Address: | 852 Gold Hill Rd Suite 206 Fort Mill |
| State: | SC US |
| Postal Code: | 297087976 |
| Phone Number: | 8036199103 |
| Fax Number: | 8665856452 |
| NPI Enumeration Date: | 06/03/2012 |
| NPI Last Update Date: | 06/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 9672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |