Healthcare Provider Details

I. General information

NPI: 1548626245
Provider Name (Legal Business Name): JESSICA LASHAY OCONNOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LASHAY MCBURNETT

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3478 MARTHA BERRY HWY NE
ROME GA
30165-7713
US

IV. Provider business mailing address

PO BOX 118
SHANNON GA
30172-0118
US

V. Phone/Fax

Practice location:
  • Phone: 706-873-9197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: