Anna Connolly, CSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11351677-3502 Issued in UT

Practice address

2655 S Lake Erie Dr
West Valley City, UT 84120-7350

Phone

(801) 856-4863

NPI assigned

Aug 22, 2019

Last updated

Aug 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1174170344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 E ATKIN AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091901",
            "telephone_number": "801-856-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 S LAKE ERIE DR",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841207350",
            "telephone_number": "801-856-4863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2057 E Atkin Ave",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841091901",
            "country_code": "US",
            "telephone_number": "801-856-4863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ANNA",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "11351677-3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "anna@projectconnection.co",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2655 S Lake Erie Dr",
            "city": "West Valley City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841207350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.