Provider Demographics
NPI:1821841461
Name:CONNER, PATRICIA (LCSW-S)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-S
Mailing Address - Street 1:15804 DE PEER CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-5321
Mailing Address - Country:US
Mailing Address - Phone:512-796-5547
Mailing Address - Fax:
Practice Address - Street 1:15804 DE PEER CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-5321
Practice Address - Country:US
Practice Address - Phone:512-796-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX354281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical