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General NPI Number Information
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NPI Number | 1083616023
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Entity Type | Individual
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Provider Name | SUZANNE MARIE O'CONNELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 333 S BEVERLY DR STE. 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4314
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Country | US
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Telephone | 213-618-2924
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Fax |
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Provider Business Mailing Address
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Address Line | 2545 THURMAN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90016-2423
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Country | US
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Telephone | 323-936-3263
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LP9774
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License Number State | CA
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