Provider Demographics
NPI:1417758111
Name:REA, DEIRDRE O'CONNOR (DNP, CNS, PMHRN-BC)
Entity type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:O'CONNOR
Last Name:REA
Suffix:
Gender:
Credentials:DNP, CNS, PMHRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 SUGAR RUM RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6952
Mailing Address - Country:US
Mailing Address - Phone:540-355-6478
Mailing Address - Fax:
Practice Address - Street 1:5525 CATAWBA HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CATAWBA
Practice Address - State:VA
Practice Address - Zip Code:24070-2115
Practice Address - Country:US
Practice Address - Phone:540-315-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00011947142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry