Provider Demographics
NPI:1114072501
Name:O'CONNELL, JOEY ELLEN (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOEY
Middle Name:ELLEN
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 NW TRINITY PL APT 25
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1927
Mailing Address - Country:US
Mailing Address - Phone:503-449-0502
Mailing Address - Fax:
Practice Address - Street 1:11456 NE KNOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-1706
Practice Address - Country:US
Practice Address - Phone:503-256-3040
Practice Address - Fax:503-256-9601
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist