Individual
MS. CONNIE AUTUMN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
39 IRON HILL RD, NEW BRITAIN, PA 18901-5308
(215) 997-8815
(215) 822-1471
Mailing address
39 IRON HILL RD, NEW BRITAIN, PA 18901-5308
(215) 997-8815
(215) 822-1471
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013754
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01663404
PERSONAL CHOICE
—
01
—
118314
MENTAL HEALTH NETWORK
—
01
—
475996
VALUE OPTIONS
—
05
—
7056198
—
PA
01
—
8033730
TRICARE
—
Enumeration date
10/10/2005
Last updated
07/08/2007
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