Provider Demographics
NPI:1427132505
Name:OCONOR, ANITA RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:RENEE
Last Name:OCONOR
Suffix:
Gender:F
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:PO BOX 1997
Mailing Address - Street 2:MS 750 CHILD PSYCHIATRY DEPT CHILDRENS HOSPITAL OF WI
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201
Mailing Address - Country:US
Mailing Address - Phone:414-266-2932
Mailing Address - Fax:
Practice Address - Street 1:1020 N 12TH STREET
Practice Address - Street 2:5TH FLOOR
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233
Practice Address - Country:US
Practice Address - Phone:414-277-8990
Practice Address - Fax:414-277-8969
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2928123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker