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General NPI Number Information
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NPI Number | 1770001109
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Entity Type | Organization
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Legal Business Name | KATHY O'CONNELL, LMFT, LLC
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 373 E MAIN ST STE 101
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-2600
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Country | US
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Telephone | 610-256-6022
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Fax |
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Provider Business Mailing Address
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Address Line | 341 MULBERRY DR
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City | ROYERSFORD
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State | PA
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Zip | 19468-1272
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Country | US
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Telephone | 610-256-6022
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHLEEN MARY O'CONNELL
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Credential | LMFT
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Telephone | 610-256-6022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000880
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License Number State | PA
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