MEDICARE: SEAMUS OCONNOR MA, MS, MT-BC

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	225A00000X	Music Therapist	09838
2	101YP2500X	Professional Counselor	PC011808	PA

General Provider Information

NPI Number	:	1902381429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAMUS OCONNOR MA, MS, MT-BC

Provider Business Mailing Address
First Line	:	209 GLEN ARBOR RD
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4727
Country	:	US
Telephone Number	:	215-847-8290
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 PARK WAY
Second Line	:
City	:	BROOMALL
State	:	PA
Zip	:	19008-4202
Country	:	US
Telephone Number	:	610-732-8683
Fax Number	:

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

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	10/01/2019

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