Provider Demographics
NPI:1861179293
Name:O'NEILL, JORDAN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HILTON HEAD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-2557
Mailing Address - Country:US
Mailing Address - Phone:186-224-8944
Mailing Address - Fax:
Practice Address - Street 1:1 HILTON HEAD UNIT 7
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-2557
Practice Address - Country:US
Practice Address - Phone:862-248-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO56670001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical