| Diane O'neill Lisw Llc | |
|
852 Gold Hill Rd Suite 206 Fort Mill SC 29708-7976 | |
| (803) 619-9103 | |
| (866) 585-6452 |
| Full Name | Diane O'neill Lisw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 852 Gold Hill Rd, Fort Mill, South Carolina |
| Authorized Official Name and Position | Diane O'neill (SOLE MEMBER/MANAGER) |
| Authorized Official Contact | 8036199103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane O'neill Lisw Llc 852 Gold Hill Rd Suite 206 Fort Mill SC 29708-7976 Ph: (803) 619-9103 | Diane O'neill Lisw Llc 852 Gold Hill Rd Suite 206 Fort Mill SC 29708-7976 Ph: (803) 619-9103 |
| NPI Number | 1003177395 |
|---|---|
| Provider Enumeration Date | 06/03/2012 |
| Last Update Date | 06/03/2012 |
| Medicare PECOS PAC ID | 6608118146 |
|---|---|
| Medicare Enrollment ID | O20190502000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003177395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 9672 (South Carolina) | Primary |
| Provider Name | Diane W O'neill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952432908 PECOS PAC ID: 9234471772 Enrollment ID: I20190502000096 |
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