Kati Connelly PHD PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

5050 Issued in NC

Legal business name

KATI CONNELLY PHD PLLC

Practice address

895 State Farm Rd Ste 504
Boone, NC 28607-4689

Phone

(703) 477-4969

NPI assigned

Jun 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Elizabeth Connelly, PHD, HSP-P

Title

Incorporator, Stockholder

Phone

(703) 477-4969

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1265926893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286070219",
            "telephone_number": "703-477-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD STE 504",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074689",
            "telephone_number": "703-477-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATI CONNELLY PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "INCORPORATOR, STOCKHOLDER",
        "authorized_official_telephone_number": "703-477-4969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, HSP-P"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "5050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1306386677",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Diane Kahle, LCSW
• Adam Joshua Kahn, M.A., LPCA
• Brielle Reice Kaluzny, LCSW
• Vojana Karan, PA-C
• Eric Karchmer, L. AC.
• Lisa Kaufmann, MD
• Madeline Lorraine Keefer, RN
• Louise Catherine Keegan, PHD,CCC-SLP
• Elizabeth Keeter, M.A. CCC-SLP
• Bettie M Keith, RN

• Counseling Psychologist in Boone, NC
• Providers in Boone, NC by specialty
• Counseling Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.