Provider Demographics
NPI:1437849064
Name:CONNOR, ANTOVISE ARNICE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTOVISE
Middle Name:ARNICE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 GREAT FALLS LOOP
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-3879
Mailing Address - Country:US
Mailing Address - Phone:904-910-7379
Mailing Address - Fax:
Practice Address - Street 1:3812 GREAT FALLS LOOP
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-3879
Practice Address - Country:US
Practice Address - Phone:904-910-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW214781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical