Provider Demographics
NPI:1386522621
Name:O'NEILL, BRENDEN
Entity type:Individual
Prefix:
First Name:BRENDEN
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SOMERS HILL CIR
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1928
Mailing Address - Country:US
Mailing Address - Phone:860-849-9982
Mailing Address - Fax:
Practice Address - Street 1:317 E CALHOUN ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3535
Practice Address - Country:US
Practice Address - Phone:860-849-9982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical