Individual
DR. MICHAEL J O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9501 OLD ANNAPOLIS RD, 125, ELLICOTT CITY, MD 21042-6314
(410) 997-1063
Mailing address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 877-1000
(202) 829-2632
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
03219
MD
103TC0700X
Clinical Psychologist
Primary
PSY1000032
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H360-0011
BCBS
DC
Enumeration date
11/24/2006
Last updated
05/09/2012
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