Provider Demographics
NPI:1376623504
Name:CONNORS, STEVEN J (LICSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:CONNORS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 LENOX ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3416
Mailing Address - Country:US
Mailing Address - Phone:781-769-8670
Mailing Address - Fax:781-769-6717
Practice Address - Street 1:190 LENOX ST
Practice Address - Street 2:RIVERSIDE OUTPATIENT CENTER AT NORWOOD
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3416
Practice Address - Country:US
Practice Address - Phone:781-769-8670
Practice Address - Fax:781-769-6717
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1051541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP04154Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER