Provider Demographics
NPI:1003217233
Name:CONNERS, LIDIA EMPERATRIZ (LCSW)
Entity Type:Individual
Prefix:
First Name:LIDIA
Middle Name:EMPERATRIZ
Last Name:CONNERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SANTIAGO DE VERAGUAS
Mailing Address - Street 2:
Mailing Address - City:VERAGUAS
Mailing Address - State:PANAMA
Mailing Address - Zip Code:507
Mailing Address - Country:PA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-2642
Practice Address - Country:US
Practice Address - Phone:913-802-3625
Practice Address - Fax:316-347-2463
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 122011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical