Individual
KATHRYN E O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
21ST MEDICAL GROUP, PETERSON SPACE FORCE BASE, CO 80914
(719) 556-7804
Mailing address
559 VINCENT STREET, SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW-4816
HI
Other
Enumeration date
10/04/2021
Last updated
04/09/2025
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