Provider Demographics
NPI:1104357805
Name:CONNECTIONS THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:CONNECTIONS THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NEVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:301-461-7039
Mailing Address - Street 1:519 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6335
Mailing Address - Country:US
Mailing Address - Phone:301-461-7039
Mailing Address - Fax:
Practice Address - Street 1:519 BROWN AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6335
Practice Address - Country:US
Practice Address - Phone:301-461-7039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health