Doctor Name: | TIMOTHY J O'CONNOR |
NPI Number: | 1124155726 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | SW5622 |
Business Practice Address: | 4720 N State Road 7 Bldg B Lauderdale Lakes, FL - 333195860 |
Business Phone Number: | 9544973850 |
Business Fax Number: | 9544973857 |
Mailing Address: | 4720 N State Road 7 Bldg B, LAUDERDALE LAKES |
State: | FL |
Postal Code: | 333195860 |
Phone Number: | 9544973850 |
Fax Number: | 9544973857 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW5622 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |