Kelly O'Connor | University Heights, OH • PECOS Search

Kelly O'Connor

Social Worker

Behavioral Health & Social Service Providers

4389 Silsby Rd, University Heights, OH 44118-3963

PECOS Enrollment

Based on the most recent information from CMS, provider Kelly O'Connor does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1164853818
Provider Type
Individual
Full Name
O'Connor, Kelly
Credential
MSSA, LISW-S

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/5/2013
Last Updated
12/5/2013

Contact Information

Practice Location

4389 Silsby Rd, University Heights, OH 44118-3963

Unlisted Fax

Mailing Location

4389 Silsby Rd, University Heights, OH 44118-3963

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I.1100153-SUPV Ohio