Provider Demographics
NPI:1790034585
Name:OCONNELL, NICOLE LINDA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:LINDA
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 METHUEN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1700
Mailing Address - Country:US
Mailing Address - Phone:978-683-3128
Mailing Address - Fax:978-682-7296
Practice Address - Street 1:12 METHUEN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1700
Practice Address - Country:US
Practice Address - Phone:978-683-3128
Practice Address - Fax:978-682-7296
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health