Provider Demographics
NPI:1669702924
Name:CONNOR, ABBY LYNN (MS, CAGS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:LYNN
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MS, CAGS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1017
Mailing Address - Country:US
Mailing Address - Phone:717-215-5734
Mailing Address - Fax:
Practice Address - Street 1:141 DAVID DRIVE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:717-215-5734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-10
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005817101YP2500X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst