Autumn, Connie

Autumn, Connie is an individual health care provider with primary practice located at 39 Iron Hill Rd , New Britain PA 18901-5308. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Autumn, Connie can be contacted via phone (215) 997-8815.

Contact Information

Primary practice address
39 Iron Hill Rd New Britain PA 18901-5308
Phone: (215) 997-8815
Fax: (215) 822-1471
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW013754 Pennsylvania

Profile Details

NPI number 1457349870
LBN Legal business name Autumn, Connie
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457349870 NPPES
Pennsylvania MEDICAID 7056198
Pennsylvania Other 01663404
Pennsylvania Other 118314
Pennsylvania Other 475996
Pennsylvania Other 8033730

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