Active NPI
Lisa Ann O'Connor, BSCASACLL
- Addiction (Substance Use Disorder) Counselor
- Rochester, NY
National Provider Identifier
1265844633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1073614533
- Practice address
- 835 W Main St
Rochester, NY 14611-2335 - Phone
- (585) 467-2230
- Fax
- (585) 730-6110
- NPI assigned
- May 20, 2014
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1073614533 | NY | Primary |
Addresses
Primary practice location
835 W Main St
Rochester, NY 14611-2335
Mailing address
2 Broxbourne Dr
Fairport, NY 14450-1719
Other practice location 1
360 East Ave
Rochester, NY 14604-2638
Phone (585) 325-5100 ext. 3566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073614533 | Medicaid | NY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1073614533 | NY | MD | Case Management Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Huther-Doyle Memorial Institute Inc | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Rochester, NY
- NPI 1033520440
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1265844633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BROXBOURNE DR",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144501719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 W MAIN ST",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146112335",
"telephone_number": "585-467-2230",
"fax_number": "585-730-6110"
}
],
"practiceLocations": [
{
"address_1": "360 East Ave",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146042638",
"country_code": "US",
"telephone_number": "585-325-5100 x3566",
"fax_number": "585-325-5154",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'CONNOR",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "BSCASACLL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-20",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "1073614533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073614533",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.