=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861826000
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | COLIN JOHN CONNOR PSY.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2013
-----------------------------------------------------
Last Update Date | 01/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 DENNISON RD
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01609-1222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-834-8878
-----------------------------------------------------
Fax | 508-804-7172
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18 LYMAN ST STE 100A1027
-----------------------------------------------------
City | WESTBOROUGH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01581-1459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-834-8878
-----------------------------------------------------
Fax | 508-804-7172
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 9791
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------