Provider Demographics
NPI:1356779292
Name:O'CONNOR, JAMIE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:LICHTENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2261
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-9061
Mailing Address - Country:US
Mailing Address - Phone:973-680-8388
Mailing Address - Fax:973-680-8803
Practice Address - Street 1:20 WATSESSING AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4613
Practice Address - Country:US
Practice Address - Phone:973-680-8388
Practice Address - Fax:973-680-8803
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00387300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional