Healthcare Provider Details

I. General information

NPI: 1669309696
Provider Name (Legal Business Name): WILLIAM JOSEPH O'CONNELL PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 BLUE WATER BLVD
ODENTON MD
21113-3309
US

IV. Provider business mailing address

12216 AMBLESIDE DR
POTOMAC MD
20854-2112
US

V. Phone/Fax

Practice location:
  • Phone: 410-941-7272
  • Fax:
Mailing address:
  • Phone: 410-941-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number03152
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: