Healthcare Provider Details

I. General information

NPI: 1770778680
Provider Name (Legal Business Name): CATHERINE O'CONNELL M.ED., LMHC, LADCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PARNELL ST
NORTH WEYMOUTH MA
02191-2121
US

IV. Provider business mailing address

16 PARNELL ST
NORTH WEYMOUTH MA
02191-2121
US

V. Phone/Fax

Practice location:
  • Phone: 781-340-9031
  • Fax:
Mailing address:
  • Phone: 781-340-9031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1141
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3696
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: