Kelly O'Connor, MSSA, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1100153-SUPV Issued in OH

Practice address

4389 Silsby Rd
University Heights, OH 44118-3963

Phone

(216) 401-7791

NPI assigned

Dec 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1164853818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4389 SILSBY RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183963",
            "telephone_number": "216-401-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 SILSBY RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183963",
            "telephone_number": "216-401-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KELLY",
        "credential": "MSSA, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1100153-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle O'Donnell
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• Alexander Oleksy
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• Clinical Social Worker in University Heights, OH
• Providers in University Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.