Provider Demographics
NPI:1639226194
Name:OCONNELL, KATHLEEN B (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:B
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 PLEASANT AVE
Mailing Address - Street 2:YARMOUTH CAMPGROUND ASSOCIATION
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-8565
Mailing Address - Country:US
Mailing Address - Phone:508-778-1677
Mailing Address - Fax:
Practice Address - Street 1:190 LENOX STREET
Practice Address - Street 2:RES
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-8565
Practice Address - Country:US
Practice Address - Phone:781-769-8674
Practice Address - Fax:781-440-0740
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health