Individual provider Active NPI

Patrick Michael O'Callaghan, PH.D.

  • Clinical Psychologist
  • Metairie, LA
National Provider Identifier
1386908754
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1077 Issued in LA
Practice address
4228 Houma Blvd
Suite 230
Metairie, LA 70006-3000
Phone
(504) 883-8911
Fax
(504) 883-3723
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1077 LA Primary

Addresses

Primary practice location

4228 Houma Blvd
Suite 230
Metairie, LA 70006-3000

Mailing address

4228 Houma Blvd
Suite 230
Metairie, LA 70006-3000
Phone (504) 883-8911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117003145 LA Practitioner - Clinical Psychologist 4587012299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Tammany Parish Hospital Service District No 1Group PAC ID 0749273761, 162 clinicians

Practice addresses (Care Compare)

201 Saint Ann Dr B
Mandeville, LA 70471-3219
Phone (985) 626-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1077LAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St Tammany Parish Hospital Service District No 1 CurrentSince Oct 3, 2023 Accepting new patients
St. Tammany Parish Hospital Service District No 1 Past Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1520 Highway 22 W
Madisonville, LA 70447
Phone (985) 773-1600

201 Saint Ann Dr
Mandeville, LA 70471
Phone (985) 612-2100

201 Saint Ann Dr
Ste B
Mandeville, LA 70471
Phone (985) 626-1717

Interoperability endpoints

  • Direct secure messaging: pocallaghan1936952@direct.ochsner.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1386908754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 230",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-883-8911",
            "fax_number": "504-883-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 230",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-883-8911",
            "fax_number": "504-883-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CALLAGHAN",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.