Individual
BRENDAN O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
55 CARLETON AVE STE 5, EAST ISLIP, NY 11730-2133
(631) 579-3503
Mailing address
280 BAY AVE, PATCHOGUE, NY 11772-4019
(631) 678-2802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
085772
NY
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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