Casey Oconnor
Individual provider Active NPI Social Worker · Menominee, MI
NPI 1164927752 · NPPES record last updated Mar 27, 2018
Key facts
- NPI
- 1164927752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802088866 (MI)
- Practice address
- 401 10TH Ave
Menominee, MI 49858-3009 - Phone
- (906) 863-7841
- NPI assigned
- Mar 27, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802088866 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802088866 | MI | Yes |
Addresses
Primary practice location
401 10TH Ave
Menominee, MI 49858-3009
Mailing address
715 Pyle Dr
Kingsford, MI 49802-4456
Other providers in Menominee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.