Active NPI
Vivian C Oconnor, LCSW
- Clinical Social Worker
- Massapequa, NY
National Provider Identifier
1265449938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0304311
- Practice address
- 19 Riverside Ave
Massapequa, NY 11758-5728 - Phone
- (516) 798-5365
- Fax
- (516) 798-5365
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0304311 | NY | Primary |
Addresses
Primary practice location
19 Riverside Ave
Massapequa, NY 11758-5728
Mailing address
19 Riverside Ave
Massapequa, NY 11758-5728
Phone (516) 798-5365
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N40721 | Other | EMPIRE BLUE CROSS BLUE SH | |
| 4353468 | Other | AETNA | |
| SF0001416 | Other | SELECT PRO | |
| 7402592 | Other | GHI GROUP HEALTH INS | |
| 038203 | Other | VALUE OPTIONS | |
| 02051921 | Medicaid | NY | |
| 141030000 | Other | MAGELLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0304311 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222732800000",
"number": "1265449938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 RIVERSIDE AVE",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117585728",
"telephone_number": "516-798-5365",
"fax_number": "516-798-5365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 RIVERSIDE AVE",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117585728",
"telephone_number": "516-798-5365",
"fax_number": "516-798-5365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OCONNOR",
"first_name": "VIVIAN",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2008-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0304311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUE CROSS BLUE SH",
"identifier": "N40721",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4353468",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT PRO",
"identifier": "SF0001416",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI GROUP HEALTH INS",
"identifier": "7402592",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "038203",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02051921",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "141030000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.