Individual provider Active NPI

Sheryl Anne Conner, PHD, LCSW, ACSW

  • Clinical Social Worker
  • Gainesville, FL
National Provider Identifier
1104025543
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5514 Issued in FL
Practice address
4101 NW 89TH Blvd
Gainesville, FL 32606-3813
Phone
(352) 627-0113
NPI assigned
Jul 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5514 FL Primary

Addresses

Primary practice location

4101 NW 89TH Blvd
Gainesville, FL 32606-3813

Mailing address

4101 NW 89TH Blvd
Gainesville, FL 32606-3813
Phone (352) 627-0113

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SW5514FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1104025543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NW 89TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326063813",
            "telephone_number": "352-627-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 89TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326063813",
            "telephone_number": "352-627-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "SHERYL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW,  ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.