Provider Demographics
NPI:1083353296
Name:O'CONNELL, COLLEEN (MSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8096 LOGAN DR
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-3489
Mailing Address - Country:US
Mailing Address - Phone:703-966-1666
Mailing Address - Fax:
Practice Address - Street 1:1608 WILLIAMS DR STE 301
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3195
Practice Address - Country:US
Practice Address - Phone:615-653-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor