Individual provider Active NPI

Jamie Lynne O'Connor, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1578853628
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7680-123 Issued in WI
Practice address
6815 N Capitol Drive
Suite 208
Milwaukee, WI 53216-2056
Phone
(414) 466-3204
Fax
(414) 466-3206
NPI assigned
Apr 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7680-123 WI Primary

Addresses

Primary practice location

6815 N Capitol Drive
Suite 208
Milwaukee, WI 53216-2056

Mailing address

2845 N 78TH St
Milwaukee, WI 53222-5020
Phone (414) 801-3945

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

LicenseStateTypeSpecialty
7680-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1578853628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 N 78TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532225020",
            "telephone_number": "414-801-3945",
            "fax_number": "414-466-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 N CAPITOL DRIVE",
            "address_2": "SUITE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162056",
            "telephone_number": "414-466-3204",
            "fax_number": "414-466-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JAMIE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7680-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.