Provider Demographics
NPI:1538717442
Name:O'NEAL, KASEY CHARLOTTE (MSW, LISW, ACHT)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:CHARLOTTE
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:MSW, LISW, ACHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12331 WATERSTONE LN APT 723
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3046
Mailing Address - Country:US
Mailing Address - Phone:419-707-9792
Mailing Address - Fax:
Practice Address - Street 1:2735 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1846
Practice Address - Country:US
Practice Address - Phone:419-318-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.22039321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical