Individual provider Active NPI

Eileen M Connolly, PHD

  • Psychologist
  • Newtown, PA
National Provider Identifier
1063582542
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS006100L Issued in PA
Practice address
6 Penns Trail
Newtown, PA 18940
Phone
(215) 321-5780
Fax
(215) 321-8155
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS006100L PA Primary

Addresses

Primary practice location

6 Penns Trail
Newtown, PA 18940

Mailing address

660 Reservoir Road
West Chester, PA 19380
Phone (215) 595-4833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000252 PA Practitioner - Clinical Psychologist 0547435265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry Today IncGroup PAC ID 7911158282, 12 clinicians

Practice addresses (Care Compare)

6 Dickinson Dr
Suite 107
Chadds Ford, PA 19317-9689
Phone (610) 361-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS006100LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Today Inc. CurrentSince Oct 16, 2012 Accepting new patients
Prospect Health Access Network, Inc. PastSince Oct 16, 2012 Accepting new patients
We Care BH LLC PastSince Apr 14, 2024 Accepting new patients
Stephen C. Lower Psychology Associates Psychologist Past Accepting new patients

Locations

6 Dickinson Dr
Ste 107
Chadds Ford, PA 19317
Phone (610) 361-9500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 RESERVOIR ROAD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "19380",
            "telephone_number": "215-595-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PENNS TRAIL",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "18940",
            "telephone_number": "215-321-5780",
            "fax_number": "215-321-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "EILEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006100L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

Verify at the official NPI Registry.