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General NPI Number Information
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NPI Number | 1447561451
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Entity Type | Individual
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Provider Name | KIMBERLY A O'CONNOR LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 1133 ROUTE 55 STE 2
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5051
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Country | US
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Telephone | 914-456-9637
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Fax |
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Provider Business Mailing Address
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Address Line | 1285 ROUTE 9 STE 7
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-4993
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Country | US
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Telephone | 914-456-9637
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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 | 077303
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0532001
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 2198229
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License Number State | NY
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