Healthcare Provider Details

I. General information

NPI: 1467861815
Provider Name (Legal Business Name): ERIN KATHLEEN O'CONNOR LCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 8TH ST UPPR
BERKELEY CA
94710-2319
US

IV. Provider business mailing address

2222 BANCROFT WAY
BERKELEY CA
94720-4301
US

V. Phone/Fax

Practice location:
  • Phone: 510-859-8775
  • Fax:
Mailing address:
  • Phone: 510-642-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801097960
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number93282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: