Provider Demographics
NPI:1760714240
Name:CONNOR, SHIREEN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHIREEN
Middle Name:
Last Name:CONNOR
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 1:1611 HEADWAY CIRCLE, BLDG. 2
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754
Mailing Address - Country:US
Mailing Address - Phone:512-615-6859
Mailing Address - Fax:512-476-1638
Practice Address - Street 1:1611 HEADWAY CIRCLE, BLDG. 2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754
Practice Address - Country:US
Practice Address - Phone:512-615-6859
Practice Address - Fax:512-476-1638
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53648104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker