Provider Demographics
NPI:1609907468
Name:O'CONNORLCSW, ROSEMARY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:O'CONNORLCSW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 W BALDWIN CT
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5975
Mailing Address - Country:US
Mailing Address - Phone:262-241-5099
Mailing Address - Fax:262-241-5054
Practice Address - Street 1:1317 W TOWNE SQUARE RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5017
Practice Address - Country:US
Practice Address - Phone:262-241-5099
Practice Address - Fax:262-241-5054
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1317-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health