Provider Demographics
NPI:1558034983
Name:MCINERNEY, CONNOR PATRICK (LMSW)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:PATRICK
Last Name:MCINERNEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BRANARD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5015
Mailing Address - Country:US
Mailing Address - Phone:713-800-0818
Mailing Address - Fax:
Practice Address - Street 1:401 BRANARD ST FL 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5015
Practice Address - Country:US
Practice Address - Phone:713-800-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69563104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker