Provider Demographics
NPI:1518327998
Name:MCCONNELL, COLLEEN ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 RIGLAW CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7192
Mailing Address - Country:US
Mailing Address - Phone:803-807-1472
Mailing Address - Fax:
Practice Address - Street 1:615 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1900
Practice Address - Country:US
Practice Address - Phone:803-469-2800
Practice Address - Fax:803-469-2857
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8807104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker