Provider Demographics
NPI:1427504059
Name:O'CONNOR, DONNA (LSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LSW, MSW
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 47
Mailing Address - Street 2:
Mailing Address - City:NEW VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07976-0047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:97 BAILEY'S MILL ROAD
Practice Address - Street 2:
Practice Address - City:NEW VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07976-0047
Practice Address - Country:US
Practice Address - Phone:973-476-5766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL059927001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical