Provider Demographics
NPI:1609045533
Name:O'CONNOR, DENA NELSON (LMFT)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:NELSON
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18805 W CATAWBA AVE STE 205A
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4609
Mailing Address - Country:US
Mailing Address - Phone:951-219-4680
Mailing Address - Fax:
Practice Address - Street 1:18805 W CATWBA AVE STE 205A
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4609
Practice Address - Country:US
Practice Address - Phone:336-844-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT52550106H00000X
NCLMFT1996106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist