Provider Demographics
NPI:1508083197
Name:O'CONNOR, TERRANCE P (LCSW - C)
Entity Type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:P
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:LCSW - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 QUAINT ACRES DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2713
Mailing Address - Country:US
Mailing Address - Phone:301-622-5471
Mailing Address - Fax:301-622-5478
Practice Address - Street 1:101 QUAINT ACRES DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2713
Practice Address - Country:US
Practice Address - Phone:301-622-5471
Practice Address - Fax:301-622-5478
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD035641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ826OtherCAREFIRST BLUE CROSS
DCG4540001OtherCAREFIRST BLUE CROSS
MDQ826OtherCAREFIRST BLUE CROSS