Provider Demographics
NPI:1124324785
Name:O'CONNOR, WILLIAM THOMAS (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 HWY 4 E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418
Mailing Address - Country:US
Mailing Address - Phone:318-649-3625
Mailing Address - Fax:318-649-5731
Practice Address - Street 1:5159 HWY 4 E
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418
Practice Address - Country:US
Practice Address - Phone:318-649-3625
Practice Address - Fax:318-649-5731
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA97591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical