Provider Demographics
NPI:1487950804
Name:CONNOR, MEREDITH MORGAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MORGAN
Last Name:CONNOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1606
Mailing Address - Country:US
Mailing Address - Phone:770-455-7111
Mailing Address - Fax:770-455-7118
Practice Address - Street 1:6645 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-1606
Practice Address - Country:US
Practice Address - Phone:770-455-7111
Practice Address - Fax:770-455-7118
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0043901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical