Provider Demographics
NPI:1447029921
Name:CONNOR, TREYE ANTHONY (SWC)
Entity type:Individual
Prefix:
First Name:TREYE
Middle Name:ANTHONY
Last Name:CONNOR
Suffix:
Gender:M
Credentials:SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 N UNION BLVD APT B4
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1103
Mailing Address - Country:US
Mailing Address - Phone:719-641-2039
Mailing Address - Fax:
Practice Address - Street 1:2420 N UNION BLVD APT B4
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1103
Practice Address - Country:US
Practice Address - Phone:719-641-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.0000001447104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker