Healthcare Provider Details

I. General information

NPI: 1679274278
Provider Name (Legal Business Name): CONNOR H MCGLINCHEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2838
US

IV. Provider business mailing address

1046 S ROOSEVELT AVE
BEXLEY OH
43209-2545
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5823
  • Fax:
Mailing address:
  • Phone: 614-561-6718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.241180
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: