Provider Demographics
NPI:1942490487
Name:CONLIN, ANNA LISA (LCSW-S)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LISA
Last Name:CONLIN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 JEFFERSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6221
Mailing Address - Country:US
Mailing Address - Phone:512-436-5723
Mailing Address - Fax:
Practice Address - Street 1:3724 JEFFERSON ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6221
Practice Address - Country:US
Practice Address - Phone:512-436-5723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8KH607OtherBCBS OF TX
TX395135201Medicaid