Individual provider Active NPI

Patrick Alan Connors, LCSW-C

  • Social Worker
  • Bel Air, MD
National Provider Identifier
1043840903
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21753 Issued in MD
Practice address
802 Bel Air Rd Ste 102
Bel Air, MD 21014-4212
Phone
(443) 760-3456
Fax
(443) 371-2638
NPI assigned
Jan 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21753 MD Primary

Addresses

Primary practice location

802 Bel Air Rd Ste 102
Bel Air, MD 21014-4212

Mailing address

800 Tydings LN Ste 200
Havre de Grace, MD 21078-2102
Phone (443) 760-3456

Other practice location 1

520 Upper Chesapeake Dr Ste 304
Bel Air, MD 21014-4375
Phone (443) 760-3456 ext. 478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21753MDMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1043840903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TYDINGS LN STE 200",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782102",
            "telephone_number": "443-760-3456",
            "fax_number": "443-371-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 BEL AIR RD STE 102",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144212",
            "telephone_number": "443-760-3456",
            "fax_number": "443-371-2638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Upper Chesapeake Dr Ste 304",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210144375",
            "country_code": "US",
            "telephone_number": "443-760-3456 x478",
            "fax_number": "443-371-2638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "PATRICK",
        "middle_name": "ALAN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-20",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.