Provider Demographics
NPI:1114028347
Name:MESSINGER, ELLEN O'CONNOR (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:O'CONNOR
Last Name:MESSINGER
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 1:670 VERNON ST.
Mailing Address - Street 2:#306
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1405
Mailing Address - Country:US
Mailing Address - Phone:510-601-6810
Mailing Address - Fax:
Practice Address - Street 1:670 VERNON ST.
Practice Address - Street 2:#306
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1405
Practice Address - Country:US
Practice Address - Phone:510-601-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 14070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health