MEDICARE: O'CONNELL COUNSELING, LLC

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
1	101YP2500X	Professional Counselor	PC005099	PA

General Provider Information

NPI Number	:	1386983476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'CONNELL COUNSELING, LLC

Provider Business Mailing Address
First Line	:	2260 SPRING RD
Second Line	:	SUITE 2
City	:	CARLISLE
State	:	PA
Zip	:	17013-8761
Country	:	US
Telephone Number	:	717-701-0407
Fax Number	:	717-442-5818

Provider Business Practice Location Address
First Line	:	2260 SPRING RD
Second Line	:	SUITE 2
City	:	CARLISLE
State	:	PA
Zip	:	17013-8761
Country	:	US
Telephone Number	:	717-701-0407
Fax Number	:	717-442-5818

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	MS. MICHELE LEE O'CONNELL
Credential	:	LPC
Telephone Number	:	717-701-0407

Provider Enumeration Date	:	02/08/2013
Last Update Date	:	02/08/2013

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