Provider Demographics
NPI:1922250380
Name:O'CONNELL, ALBERT R III (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:R
Last Name:O'CONNELL
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2315
Mailing Address - Country:US
Mailing Address - Phone:631-288-4794
Mailing Address - Fax:
Practice Address - Street 1:37 MAPLE ST
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2010
Practice Address - Country:US
Practice Address - Phone:631-288-4794
Practice Address - Fax:631-763-1256
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0597481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical