Active NPI
Judith Cleary Connell, LPC
- Professional Counselor
- Lynchburg, VA
National Provider Identifier
1205842622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701001192
- Practice address
- 18697 Forest Rd
The Madeline Center
Lynchburg, VA 24502-4363 - Phone
- (434) 239-0003
- Fax
- (434) 239-0181
- NPI assigned
- Jul 31, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701001192 | VA | Primary |
Addresses
Primary practice location
18697 Forest Rd
The Madeline Center
Lynchburg, VA 24502-4363
Mailing address
960 Rothowood Rd
Lynchburg, VA 24503-1114
Phone (434) 239-0003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5414784 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701001192 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205842622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 ROTHOWOOD RD",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245031114",
"telephone_number": "434-239-0003",
"fax_number": "434-239-0181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18697 FOREST RD",
"address_2": "THE MADELINE CENTER",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245024363",
"telephone_number": "434-239-0003",
"fax_number": "434-239-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL",
"first_name": "JUDITH",
"middle_name": "CLEARY",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701001192",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5414784",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.