Patrick Allen O'Connell, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002253A Issued in IN

Practice address

322 W Jefferson St
Plymouth, IN 46563-1734

Phone

(574) 936-3377

Fax

(574) 936-3910

NPI assigned

Jun 29, 2010

Last updated

Aug 13, 2015By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Eric Foster, Inc.

  • Mental Health Counselor
  • Plymouth, IN
  • NPI 1437478864
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1255642740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W JEFFERSON ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631734",
            "telephone_number": "574-936-3377",
            "fax_number": "574-936-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W JEFFERSON ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631734",
            "telephone_number": "574-936-3377",
            "fax_number": "574-936-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "PATRICK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002253A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200400060",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.