Provider Demographics
NPI:1043946114
Name:O'CONNELL, DREW ALAN (BA, ADC-IP)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:ALAN
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:BA, ADC-IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GADSDEN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1145
Mailing Address - Country:US
Mailing Address - Phone:843-352-9982
Mailing Address - Fax:
Practice Address - Street 1:65 GADSDEN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1145
Practice Address - Country:US
Practice Address - Phone:843-352-9982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1234OtherSUBSTANCE ABUSE COUNSELING