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NPI Code Detail

MEDICARE: WHITNEY O'CONNOR MSW, LCSW

MEDICARE: WHITNEY O'CONNOR MSW, LCSW
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 Worker2017032176MO

General Provider Information

NPI Number : 1477091056
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY O'CONNOR MSW, LCSW
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5000
Fax Number :
Provider Business Practice Location Address
First Line : 105 E ASH ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-4094
Country : US
Telephone Number : 573-777-7530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2017
Last Update Date : 09/26/2024

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