Provider Demographics
NPI:1043840903
Name:CONNORS, PATRICK ALAN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALAN
Last Name:CONNORS
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 TYDINGS LN STE 200
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2102
Mailing Address - Country:US
Mailing Address - Phone:443-760-3456
Mailing Address - Fax:443-371-2638
Practice Address - Street 1:802 BEL AIR RD STE 102
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4212
Practice Address - Country:US
Practice Address - Phone:443-760-3456
Practice Address - Fax:443-371-2638
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21753104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker