Timothy J O'Connor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5622 Issued in FL

Practice address

4720 N State Road 7 BLDG B
Lauderdale Lakes, FL 33319-5860

Phone

(954) 497-3850

Fax

(954) 497-3857

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Timothy O'Connor, L.C.S.W., P.a.

  • Adult Mental Health Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1821436130
  Medicare reassignment NPD Authorized official
• Henderson Behavioral Health, Inc.

  • Community Health Clinic/Center
  • Lauderdale Lakes, FL
  • NPI 1043880156
  NPD (past)
• Psychiatric Consulting and Counseling Inc

  • Psychiatry Physician
  • Sunrise, FL
  • NPI 1801957188
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124155726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 N STATE ROAD 7 BLDG B",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195860",
            "telephone_number": "954-497-3850",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 N STATE ROAD 7 BLDG B",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195860",
            "telephone_number": "954-497-3850",
            "fax_number": "954-497-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763866300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Broward Hospital District
• North Shore Medical Center, Inc.
• Notre Dame Chiropractic Center, Inc.
• Nova Southeastern University, Inc
• Nucleus Medical Inc
• Daniel O'Malley
• Oakland Dental, LLC
• Oakland Dialysis Center LLC
• Charite Octave
• Lynda Odera, APRN

• Clinical Social Worker in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.