Provider Demographics
NPI:1427054238
Name:O'CONNOR, RICHARD (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PETTEE ST.
Mailing Address - Street 2:BOX 551
Mailing Address - City:LAKEVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06039-0551
Mailing Address - Country:US
Mailing Address - Phone:860-824-7423
Mailing Address - Fax:860-435-0588
Practice Address - Street 1:32 PETTEE ST
Practice Address - Street 2:BOX 551
Practice Address - City:LAKEVILLE
Practice Address - State:CT
Practice Address - Zip Code:06039-1222
Practice Address - Country:US
Practice Address - Phone:860-824-7423
Practice Address - Fax:860-435-0588
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00021331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical