Provider Demographics
NPI:1992014617
Name:CONNORS, JOHN K (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:CONNORS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11104 AMESITE TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-2419
Mailing Address - Country:US
Mailing Address - Phone:512-401-3539
Mailing Address - Fax:
Practice Address - Street 1:11104 AMESITE TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-2419
Practice Address - Country:US
Practice Address - Phone:512-401-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO245101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor