Individual
COLIN O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-4910
Mailing address
PO BOX 588, BENNINGTON, VT 05201-0588
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
068-0000207
VT
101YM0800X
Mental Health Counselor
068-0000207
VT
103T00000X
Psychologist
068-0000207
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007295
—
VT
01
—
2032396
CIGNA
—
01
—
29944
BLUE CROSS
—
01
—
359412
MANAGED HEALTH NET
—
Enumeration date
08/05/2006
Last updated
03/21/2008
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