Provider Demographics
NPI:1306901764
Name:O'CONNOR, STEPHEN JOSEPH (MFT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 HOWARD RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5805
Mailing Address - Country:US
Mailing Address - Phone:202-527-0840
Mailing Address - Fax:
Practice Address - Street 1:821 HOWARD RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5805
Practice Address - Country:US
Practice Address - Phone:202-527-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist