Active NPI
Chad R Connor, LCSW
- Clinical Social Worker
- Evansville, IN
National Provider Identifier
1265096218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006456A
- Practice address
- 15 Vann Ave
Evansville, IN 47714-1444 - Phone
- (812) 402-8333
- Fax
- (812) 402-8331
- NPI assigned
- Apr 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34006456A | IN | Primary |
Addresses
Primary practice location
15 Vann Ave
Evansville, IN 47714-1444
Mailing address
PO Box 33
Evansville, IN 47701-0033
Phone (812) 473-0181
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1265096218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477010033",
"telephone_number": "812-473-0181",
"fax_number": "812-473-5822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 VANN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477141444",
"telephone_number": "812-402-8333",
"fax_number": "812-402-8331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOR",
"first_name": "CHAD",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-25",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006456A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.