Patrick R Connelly, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

44SC05182000 Issued in NJ

Practice address

3069 English Creek Ave
Suite 224
Egg Harbor Township, NJ 08234-9708

Phone

(609) 780-3570

NPI assigned

Dec 8, 2006

Last updated

Feb 14, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mindful Counseling Center LLC

  • Clinical Social Worker
  • Egg Harbor Township, NJ
  • NPI 1164832192
  NPD Authorized official
• Atlanticare Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Hammonton, NJ
  • NPI 1093873556

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1417016908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 ENGLISH CREEK AVE",
            "address_2": "SUITE 224",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349708",
            "telephone_number": "609-780-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3069 ENGLISH CREEK AVE",
            "address_2": "SUITE 224",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349708",
            "telephone_number": "609-780-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "PATRICK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05182000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Collins, MD
• Stephanie Marie Colon, MS, CCC-SLP
• Community Options Enterprises, Inc.
• Community Quest
• Community Quest
• Ada Contreras, APN
• John H Cooper, DO
• Ronni Laura Copeland
• Gisel Corado-Lemus
• Annemarie Corbett

• Mental Health Counselor in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.

Verify at the official NPI Registry.