Healthcare Provider Details

I. General information

NPI: 1063028223
Provider Name (Legal Business Name): MICHAEL C O'HARA LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 08/07/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT # 15245 ; BLDG 3031
APO AP
96271
US

IV. Provider business mailing address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT # 15245 ; BLDG 3031
APO AP
96271
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-4237
  • Fax:
Mailing address:
  • Phone: 315-737-4237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW-2769
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW2769
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: