Provider Demographics
NPI:1174668313
Name:CONNOR, TRACI (LMHC)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:CONNOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CHANDLER RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2828
Mailing Address - Country:US
Mailing Address - Phone:978-409-2058
Mailing Address - Fax:
Practice Address - Street 1:78 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3851
Practice Address - Country:US
Practice Address - Phone:978-273-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2994101YM0800X
MALMHC7792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health