Basic Information
| Provider Information | |||||||||
| NPI: | 1700087947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'NEAL | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | KAY | ||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GOBLE | ||||||||
| OtherFirstName: | LINDA | ||||||||
| OtherMiddleName: | KAY | ||||||||
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| OtherCredential: | LMSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 909 E 13TH ST | ||||||||
| Address2: | |||||||||
| City: | EUDORA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660258927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7856907403 | ||||||||
| FaxNumber: | 3162839540 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 S CLAIRBORNE RD | ||||||||
| Address2: | ST 2 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133907816 | ||||||||
| FaxNumber: | 3162839540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | LMSW 4408 | KS | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.