Provider Demographics
NPI:1558537712
Name:CONNOR, BEVERLEY A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BEVERLEY
Middle Name:A
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65516 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-8406
Mailing Address - Country:US
Mailing Address - Phone:985-788-2259
Mailing Address - Fax:985-727-2111
Practice Address - Street 1:65516 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-8406
Practice Address - Country:US
Practice Address - Phone:985-788-2259
Practice Address - Fax:985-727-2111
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA81071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical