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NPI Code Detail

MEDICARE: MS. JULIE A. O'CONNOR LICSW

MEDICARE: MS. JULIE A. O'CONNOR LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW01301RI

General Provider Information

NPI Number : 1013216126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE A. O'CONNOR LICSW
Provider Business Mailing Address
First Line : 3445 POST RD
Second Line : C/O J. ARTHUR MEMORIAL TRUDEAU CENTER
City : WARWICK
State : RI
Zip : 02886-7147
Country : US
Telephone Number : 401-739-2700
Fax Number : 401-921-5493
Provider Business Practice Location Address
First Line : 3445 POST RD
Second Line : C/O J. ARTHUR MEMORIAL TRUDEAU CENTER
City : WARWICK
State : RI
Zip : 02886-7147
Country : US
Telephone Number : 401-739-2700
Fax Number : 401-921-5493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 11/17/2015

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