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NPI Code Detail

MEDICARE: COLLEEN M O'CONNOR LCSW

MEDICARE:   COLLEEN M O'CONNOR  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 WorkerLC11041ME

General Provider Information

NPI Number : 1912916321
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN M O'CONNOR LCSW
Provider Business Mailing Address
First Line : 100 CAMPUS DR UNIT 121
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7172
Country : US
Telephone Number : 207-396-7788
Fax Number : 207-396-7525
Provider Business Practice Location Address
First Line : 100 CAMPUS DR UNIT 121
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7172
Country : US
Telephone Number : 207-396-7788
Fax Number : 207-396-8500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 02/25/2026

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Directions to “ COLLEEN M O'CONNOR LCSW” Practice Location

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