Active NPI
Colin O'Connor, LCMHC
- Counselor
- Bennington, VT
National Provider Identifier
1700895158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 068-0000207
- Practice address
- 100 Ledgehill Rd
Bennington, VT 05201-2273 - Phone
- (802) 442-5491
- Fax
- (802) 442-4910
- NPI assigned
- Aug 5, 2006
- Last updated
- Mar 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 068-0000207 | VT | Primary |
| Mental Health Counselor | 101YM0800X | 068-0000207 | VT | |
| Psychologist | 103T00000X | 068-0000207 | VT |
Addresses
Primary practice location
100 Ledgehill Rd
Bennington, VT 05201-2273
Mailing address
PO Box 588
Bennington, VT 05201-0588
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29944 | Other | BLUE CROSS | |
| 1007295 | Medicaid | VT | |
| 2032396 | Other | CIGNA | |
| 359412 | Other | MANAGED HEALTH NET |
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 |
|---|---|---|---|
| 068-0000207 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206057600000",
"number": "1700895158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 588",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052010588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 LEDGEHILL RD",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052012273",
"telephone_number": "802-442-5491",
"fax_number": "802-442-4910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "COLIN",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2008-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VT",
"license": "068-0000207",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068-0000207",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "068-0000207",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "29944",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007295",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2032396",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NET",
"identifier": "359412",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.