Provider Demographics
NPI:1194871350
Name:CONNER, DONNIE GRAY (LPC)
Entity type:Individual
Prefix:DR
First Name:DONNIE
Middle Name:GRAY
Last Name:CONNER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 GROVE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2220
Mailing Address - Country:US
Mailing Address - Phone:804-359-2424
Mailing Address - Fax:804-359-0029
Practice Address - Street 1:3500 GROVE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2220
Practice Address - Country:US
Practice Address - Phone:804-359-2424
Practice Address - Fax:804-359-0029
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health