Provider Demographics
NPI:1740939594
Name:O'CONNOR, CHERYL ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4730
Mailing Address - Country:US
Mailing Address - Phone:941-266-6832
Mailing Address - Fax:
Practice Address - Street 1:3636 S SHADE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6298
Practice Address - Country:US
Practice Address - Phone:941-361-6472
Practice Address - Fax:941-361-6508
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW19321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health