Individual
JOHN O'ROURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6365
(203) 301-2397
Mailing address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008050
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004039244
—
CT
01
—
77ABH0005CT01
ANTHEM
—
01
—
ANC1406
OXFORD
CT
Enumeration date
05/08/2013
Last updated
05/08/2013
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