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General NPI Number Information
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NPI Number | 1285215335
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Entity Type | Organization
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Legal Business Name | M. KIM O'CONNOR, LCSW, PLLC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 14 ELM PLACE SUITE 200
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City | RYE
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State | NY
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Zip | 10580-2951
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Country | US
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Telephone | 917-453-2328
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Fax | 914-925-9839
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Provider Business Mailing Address
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Address Line | 14 ELM PLACE SUITE 200
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City | RYE
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State | NY
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Zip | 10580-2951
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Country | US
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Telephone | 917-453-2328
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Fax | 914-925-9839
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER/OWNER
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Name | MS. MARY KIMBERLY O'CONNOR
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Credential | LCWSW-R
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Telephone | 917-453-2328
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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 |
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License Number State |
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