Provider Demographics
NPI:1396364618
Name:OHLAND, CONOR R (LMHC)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:R
Last Name:OHLAND
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SYCAMORE AVE
Mailing Address - Street 2:#39
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716
Mailing Address - Country:US
Mailing Address - Phone:631-758-8290
Mailing Address - Fax:631-333-7888
Practice Address - Street 1:872 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:ST. JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780
Practice Address - Country:US
Practice Address - Phone:631-758-8290
Practice Address - Fax:631-333-7888
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013940-01101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health