Individual
TYRONE JEROME MCCONNICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
196 MAGNOLIA ST, HARTFORD, CT 06112-2407
(860) 985-2627
Mailing address
PO BOX 4393, HARTFORD, CT 06147-4393
(860) 985-2627
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
009688
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009688
LICENSE
CT
Enumeration date
02/24/2017
Last updated
02/10/2022
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