Provider Demographics
NPI:1053196113
Name:MEERS, CONNOR RICHARD (LICSW)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:RICHARD
Last Name:MEERS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 CALIFORNIA DR APT 103
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-2208
Mailing Address - Country:US
Mailing Address - Phone:320-249-5624
Mailing Address - Fax:
Practice Address - Street 1:1180 CALIFORNIA DR APT 103
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-2208
Practice Address - Country:US
Practice Address - Phone:320-249-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical