Carrie Lee O'Connor, LGSW

Key facts

NPI

1699217646

Entity type

Individual (NPI type 1)

Primary specialty

Social Worker 104100000X

License

22336 (MD)

Practice address

602 Little Kidwell Ave
Centreville, MD 21617-1215

Phone

(443) 350-3743

NPI assigned

Nov 8, 2016

Sex

Female

Sole proprietor

Yes

Organizations & group practices 8

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.

• Fello Inc Mental Health Clinic/Center (Including Community Mental Health Center) · Severn, MD · NPI 1215515341
  Medicare reassignment Care Compare group NPD MD
• Bridges Behavioral Health & Wellness Community/Behavioral Health Agency · Centreville, MD · NPI 1205193737
  Medicare reassignment NPD MD
• Luminis Health Medical Group, LLC Maternal & Fetal Medicine Physician · Annapolis, MD · NPI 1073580205
  Medicare reassignment NPD MD
• Live Life Now Health Group PA Addiction Medicine (Family Medicine) Physician · Yonkers, NY · NPI 1770111429
  Medicare reassignment NPD MD
• Fello Inc Mental Health Clinic/Center (Including Community Mental Health Center) · Annapolis, MD · NPI 1649143116
  NPD
• Luminis Health Medical Group, LLC Plastic and Reconstructive Surgery Physician · Annapolis, MD · NPI 1134416688
  NPD
• Luminis Health Medical Group, LLC Internal Medicine Physician · Bowie, MD · NPI 1720835010
  NPD
• Fello Inc Mental Health Clinic/Center (Including Community Mental Health Center) · Easton, MD · NPI 1992679419
  NPD (past)

Medicare Care Compare profile

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fello Inc (5 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 5, 2023.

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1699217646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 LITTLE KIDWELL AVE",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171215",
            "telephone_number": "443-350-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 LITTLE KIDWELL AVE",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171215",
            "telephone_number": "443-350-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "CARRIE",
        "middle_name": "LEE",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "22336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Centreville, MD · Social Worker in Maryland