MEDICARE: HEATHER O'CONNELL LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.1700555	OH
2	101YM0800X	Mental Health Counselor	E.2102512	OH

General Provider Information

NPI Number	:	1427564939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER O'CONNELL LPCC

Provider Business Mailing Address
First Line	:	378 S MAIN ST APT 4
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-2149
Country	:	US
Telephone Number	:	440-225-4782
Fax Number	:

Provider Business Practice Location Address
First Line	:	1865 N RIDGE RD E STE D
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3359
Country	:	US
Telephone Number	:	440-324-5701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	10/06/2021

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Directions to “ HEATHER O'CONNELL LPCC” Practice Location

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