Connie, Elliott Eugene

Connie, Elliott Eugene is an individual health care provider with primary practice located at 1400 S Main St Suite 509, Fort Worth TX 76104-4909. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Connie, Elliott Eugene can be contacted via phone (817) 870-1080.

Contact Information

Primary practice address
1400 S Main St Suite 509 Fort Worth TX 76104-4909
Phone: (817) 870-1080
Fax: (817) 870-1085
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 62681 Texas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 62681 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 62681 Texas

Profile Details

NPI number 1568503506
LBN Legal business name Connie, Elliott Eugene
Credentials LPC-I
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2007
Last updated Jul 10th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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