1659354496 NPI number — MR. SCOTT ANTHONY O'NEAL LCSW

Table of content: MR. SCOTT ANTHONY O'NEAL LCSW (NPI 1659354496)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659354496 NPI number — MR. SCOTT ANTHONY O'NEAL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'NEAL
Provider First Name:
SCOTT
Provider Middle Name:
ANTHONY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659354496
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10833
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816-0833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-382-3881
Provider Business Mailing Address Fax Number:
808-841-4488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1481 S KING ST
Provider Second Line Business Practice Location Address:
SUITE 544
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-382-3881
Provider Business Practice Location Address Fax Number:
808-841-4488
Provider Enumeration Date:
11/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW-3231 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000251686 . This is a "HMSA PPO/65C" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 53222701 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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