Provider Demographics
NPI:1013216126
Name:O'CONNOR, JULIE A (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:BRADFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3445 POST RD
Mailing Address - Street 2:C/O J. ARTHUR MEMORIAL TRUDEAU CENTER
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7147
Mailing Address - Country:US
Mailing Address - Phone:401-739-2700
Mailing Address - Fax:401-921-5493
Practice Address - Street 1:3445 POST RD
Practice Address - Street 2:C/O J. ARTHUR MEMORIAL TRUDEAU CENTER
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7147
Practice Address - Country:US
Practice Address - Phone:401-739-2700
Practice Address - Fax:401-921-5493
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW013011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical