Active NPI
Andrea H Conner, LPA
- Clinical Psychologist
- Wilmington, NC
National Provider Identifier
1760569669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2328
- Practice address
- 1612 Doctors Cir
Wilmington, NC 28401-7406 - Phone
- (910) 762-1190
- Fax
- (910) 762-1195
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2328 | NC | Primary |
| Mental Health Counselor | 101YM0800X | 2328 | NC | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2328 | NC | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 2328 | NC | |
| Group Psychotherapy Psychologist | 103TP2701X | 2328 | NC | |
| Family Psychologist | 103TF0000X | 2328 | NC |
Addresses
Primary practice location
1612 Doctors Cir
Wilmington, NC 28401-7406
Mailing address
10249 Timber Ridge CT SE
Leland, NC 28451-8536
Phone (910) 599-4857
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107336 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2328 | NC | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1760569669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10249 TIMBER RIDGE CT SE",
"city": "LELAND",
"state": "NC",
"postal_code": "284518536",
"telephone_number": "910-599-4857",
"fax_number": "910-762-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1612 DOCTORS CIR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017406",
"telephone_number": "910-762-1190",
"fax_number": "910-762-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNER",
"first_name": "ANDREA",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2328",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "2328",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "2328",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NC",
"license": "2328",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NC",
"license": "2328",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NC",
"license": "2328",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107336",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
- Jordan Conklin, LMFTA
- Martin James Conley Jr., MD
- Elizabeth Conmy, MA, LPA
- Connections Physical Therapy, LLC
- Catherine Elizabeth Connell, PT, DPT
- Lakenya Nichelle Conner, LCSWA, LCASA
- Jessica Scheel Connett, MD
- Conquer Movement LLC
- Conrad, Arne', Lombardo, & Krupa, D.D.S, P.a.
- Conrad, Arne', Lombardo, & Krupa, D.D.S., P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.