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NPI Code Detail

MEDICARE: MATHEW RYAN O'CONNOR MA, LCMHC, LCAS

MEDICARE: MATHEW RYAN O'CONNOR MA, LCMHC, LCAS
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
1101YM0800XMental Health CounselorLPC.0014070CO
2101YM0800XMental Health Counselor15233NC
3101YA0400XAddiction (Substance Use Disorder) Counselor21098NC
4101YM0800XMental Health CounselorLPC010427GA

General Provider Information

NPI Number : 1932676608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATHEW RYAN O'CONNOR MA, LCMHC, LCAS
Provider Business Mailing Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number :
Provider Business Practice Location Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number : 828-544-1201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2018
Last Update Date : 07/31/2025

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