| Cathy Supon Connor Llc | |
|
429 S Tyndall Pkwy Ste G Panama City FL 32404-6746 | |
| (850) 381-3701 | |
| Not Available |
| Full Name | Cathy Supon Connor Llc |
|---|---|
| Speciality | Social Worker |
| Location | 429 S Tyndall Pkwy Ste G, Panama City, Florida |
| Authorized Official Name and Position | Cathy Supon Connor (LCSW/OWNER) |
| Authorized Official Contact | 8503811520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cathy Supon Connor Llc 429 S Tyndall Pkwy Ste G Panama City FL 32404-6746 Ph: (850) 381-3701 | Cathy Supon Connor Llc 429 S Tyndall Pkwy Ste G Panama City FL 32404-6746 Ph: (850) 381-3701 |
| NPI Number | 1669897443 |
|---|---|
| Provider Enumeration Date | 03/03/2014 |
| Last Update Date | 05/23/2014 |
| Medicare PECOS PAC ID | 7012130800 |
|---|---|
| Medicare Enrollment ID | O20140523000961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669897443 | NPI | - | NPPES |
| 769063100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW8892 (Florida) | Primary |
| Provider Name | Cathy S Connor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063698025 PECOS PAC ID: 7719003573 Enrollment ID: I20100929000814 |
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