Active NPI
Kathleen Elizabeth Connelly, PHD
- Counseling Psychologist
- Boone, NC
National Provider Identifier
1306386677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 5050
- Practice address
- 614 Howard St
Boone, NC 28608-0020 - Phone
- (703) 477-4969
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5050 | NC | Primary |
Addresses
Primary practice location
614 Howard St
Boone, NC 28608-0020
Mailing address
614 Howard St
Boone, NC 28608-0020
Phone (703) 477-4969
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5050 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488758400000",
"number": "1306386677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 HOWARD ST",
"city": "BOONE",
"state": "NC",
"postal_code": "286080020",
"telephone_number": "703-477-4969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 HOWARD ST",
"city": "BOONE",
"state": "NC",
"postal_code": "286080020",
"telephone_number": "703-477-4969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "KATHLEEN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-06",
"last_updated": "2017-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NC",
"license": "5050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.