Provider Demographics
NPI:1588730188
Name:O'HARA, COLLEEN MARGARET (LCPC)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:MARGARET
Last Name:O'HARA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 W COLLEGE DR
Mailing Address - Street 2:212
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1775
Mailing Address - Country:US
Mailing Address - Phone:708-429-2273
Mailing Address - Fax:708-429-2295
Practice Address - Street 1:6600 W COLLEGE DR
Practice Address - Street 2:212
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1775
Practice Address - Country:US
Practice Address - Phone:708-528-1771
Practice Address - Fax:708-429-2295
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional