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General NPI Number Information
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NPI Number | 1720767296
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Entity Type | Individual
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Provider Name | ANNA O'CONNOR LICSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 1455 NW LEARY WAY STE 400
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City | SEATTLE
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State | WA
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Zip | 98107-5138
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Country | US
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Telephone | 646-450-7748
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Fax |
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Provider Business Mailing Address
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Address Line | 134 N 4TH ST OFC 2010
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City | BROOKLYN
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State | NY
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Zip | 11249-3296
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Country | US
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Telephone |
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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 | LCSW-43854
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License Number State | ID
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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 | LW61407361
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License Number State | WA
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