MEDICARE: DR. COLIN JOHN CONNOR PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	9791	MA

General Provider Information

NPI Number	:	1861826000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLIN JOHN CONNOR PSY.D.

Provider Business Mailing Address
First Line	:	18 LYMAN ST STE 100A1027
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1459
Country	:	US
Telephone Number	:	508-834-8878
Fax Number	:	508-804-7172

Provider Business Practice Location Address
First Line	:	6 DENNISON RD
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1222
Country	:	US
Telephone Number	:	508-834-8878
Fax Number	:	508-804-7172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2013
Last Update Date	:	01/28/2026

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