Active NPI
Jennifer Erin O'Connor, LICSW
- Clinical Social Worker
- Hudson, WI
National Provider Identifier
1669822763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8573 - 123
- Practice address
- 2501 Hanley Rd
Suite 202
Hudson, WI 54016-8705 - Phone
- (715) 381-1980
- NPI assigned
- Jun 20, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8573 - 123 | WI | Primary |
| Clinical Social Worker | 1041C0700X | 20291 | MN |
Addresses
Primary practice location
2501 Hanley Rd
Suite 202
Hudson, WI 54016-8705
Mailing address
2501 Hanley Rd
Suite 202
Hudson, WI 54016-8705
Phone (715) 381-1980
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 |
|---|---|---|---|
| 20291 | MN | MD | Clinical Social Worker |
| 8573 - 123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Refresh Midwest Operations, SC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Hudson, WI
- NPI 1932625357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487894400000",
"number": "1669822763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 HANLEY RD",
"address_2": "SUITE 202",
"city": "HUDSON",
"state": "WI",
"postal_code": "540168705",
"telephone_number": "715-381-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 HANLEY RD",
"address_2": "SUITE 202",
"city": "HUDSON",
"state": "WI",
"postal_code": "540168705",
"telephone_number": "715-381-1980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "JENNIFER",
"middle_name": "ERIN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-20",
"last_updated": "2017-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "8573 - 123",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "20291",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.