Provider Demographics
NPI:1851899546
Name:O'CONNELL, JANICE LYNETTE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNETTE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2724
Mailing Address - Country:US
Mailing Address - Phone:361-249-7629
Mailing Address - Fax:
Practice Address - Street 1:613 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2724
Practice Address - Country:US
Practice Address - Phone:361-249-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional