Provider Demographics
NPI:1104025543
Name:CONNER, SHERYL ANNE (PHD, LCSW, ACSW)
Entity type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:ANNE
Last Name:CONNER
Suffix:
Gender:F
Credentials:PHD, LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 NW 89TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3813
Mailing Address - Country:US
Mailing Address - Phone:352-627-0113
Mailing Address - Fax:
Practice Address - Street 1:4101 NW 89TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-3813
Practice Address - Country:US
Practice Address - Phone:352-627-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW55141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical