Provider Demographics
NPI:1376979005
Name:CONNER, JANET (LCPC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 833
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-0833
Mailing Address - Country:US
Mailing Address - Phone:443-249-8673
Mailing Address - Fax:443-746-2210
Practice Address - Street 1:116 S PINEY RD STE 204C
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2961
Practice Address - Country:US
Practice Address - Phone:443-249-8673
Practice Address - Fax:443-746-2210
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005581101YP2500X
MDLC6099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional