Cathy Supon Connor LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8892 Issued in FL

Legal business name

CATHY SUPON CONNOR LLC

Practice address

429 S Tyndall Pkwy Ste G
Panama City, FL 32404-6746

Phone

(850) 381-3701

NPI assigned

Mar 3, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Cathy Supon Connor, LCSWNPI 1063698025

Title

LCSW/Owner

Phone

(850) 381-1520

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cathy Supon Connor, LCSW

  • Clinical Social Worker
  • Port St Joe, FL
  • NPI 1063698025
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1669897443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 S TYNDALL PKWY STE G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324046746",
            "telephone_number": "850-381-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 S TYNDALL PKWY STE G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324046746",
            "telephone_number": "850-381-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHY SUPON CONNOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "SUPON",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "850-381-1520",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769063100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Panama City, FL
• Providers in Panama City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.