Provider Demographics
NPI:1437835923
Name:CONN, FREDERICK LEWIS II
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:LEWIS
Last Name:CONN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 S HEGRY CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3510
Mailing Address - Country:US
Mailing Address - Phone:513-787-7199
Mailing Address - Fax:
Practice Address - Street 1:3041 S HEGRY CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3510
Practice Address - Country:US
Practice Address - Phone:513-787-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health