Provider Demographics
NPI:1154668218
Name:O'CONNELL, DANIEL JAMES KEEGAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JAMES KEEGAN
Last Name:O'CONNELL
Suffix:
Gender:M
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:PO BOX 1381
Mailing Address - Street 2:
Mailing Address - City:JOSHUA TREE
Mailing Address - State:CA
Mailing Address - Zip Code:92252-0880
Mailing Address - Country:US
Mailing Address - Phone:310-745-0963
Mailing Address - Fax:
Practice Address - Street 1:69930 HIGHWAY 111 STE 204H
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2853
Practice Address - Country:US
Practice Address - Phone:760-422-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60275104100000X
CALCSW810741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker