Connor Wills

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

37AC00547100 Issued in NJ

Practice address

80 W Main St
Mendham, NJ 07945-1257

Phone

(973) 543-5656

NPI assigned

Feb 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1376903674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 BERKELEY AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035001",
            "telephone_number": "201-572-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451257",
            "telephone_number": "973-543-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "389 Berkeley Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "NJ",
            "postal_code": "070035001",
            "country_code": "US",
            "telephone_number": "201-572-8542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLS",
        "first_name": "CONNOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2022-01-21",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37AC00547100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Mendham, NJ
• Providers in Mendham, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.