Provider Demographics
NPI:1386471092
Name:LOUGHLIN, CONNOR WORTH (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:WORTH
Last Name:LOUGHLIN
Suffix:
Gender:M
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 ERATH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5021
Mailing Address - Country:US
Mailing Address - Phone:254-715-2459
Mailing Address - Fax:
Practice Address - Street 1:400 AUSTIN AVE STE 300
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-2122
Practice Address - Country:US
Practice Address - Phone:254-715-2469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional