Provider Demographics
NPI:1891127353
Name:CONNER, ABBIE R (LCSW)
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:R
Last Name:CONNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CRESTRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3934
Mailing Address - Country:US
Mailing Address - Phone:970-494-9761
Mailing Address - Fax:970-377-0967
Practice Address - Street 1:1250 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4461
Practice Address - Country:US
Practice Address - Phone:970-494-9870
Practice Address - Fax:970-377-0967
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0006703101YA0400X
COCSW.099230281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)