Provider Demographics
NPI:1558337535
Name:O'CONNOR, NEIL JOSEPH (ACSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:JOSEPH
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2786 NORTHWYNDE PSGE
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9122
Mailing Address - Country:US
Mailing Address - Phone:608-837-4691
Mailing Address - Fax:
Practice Address - Street 1:706 WILLIAMSON ST
Practice Address - Street 2:MADISON VET CENTER SUITE 4
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4615
Practice Address - Country:US
Practice Address - Phone:608-264-5342
Practice Address - Fax:608-264-5344
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1348-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical