| Doctor Name: | MR. ELLIOTT EUGENE CONNIE |
| NPI Number: | 1568503506 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC-I |
| License Number: | 62681 |
| Business Practice Address: | 1400 S Main St Suite 509 Fort Worth, TX - 761044909 |
| Business Phone Number: | 8178701080 |
| Business Fax Number: | 8178701085 |
| Mailing Address: | 3304 Tranquility Dr, ARLINGTON |
| State: | TX |
| Postal Code: | 760162057 |
| Phone Number: | 8174573221 |
| Fax Number: | |
| NPI Enumeration Date: | 02/11/2007 |
| NPI Last Update Date: | 07/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 62681 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |