Michael C Connolly

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 4717 Issued in FL

Legal business name

MICHAEL C CONNOLLY

Practice address

8825 Perimeter Park Blvd Ste 602
Jacksonville, FL 32216-1122

Phone

(904) 234-7803

NPI assigned

Mar 4, 2016

Organization subpart

No

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

Authorized official

Name

Michael Connolly, LMHCNPI 1952424616

Title

Licensed Clinician

Phone

(904) 234-7803

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Charles Connolly, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1952424616
  NPD (past) Authorized official

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1437519352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PIPER PL",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594320",
            "telephone_number": "904-234-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 PERIMETER PARK BLVD STE 602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161122",
            "telephone_number": "904-234-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C CONNOLLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "LICENSED CLINICIAN",
        "authorized_official_telephone_number": "904-234-7803",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 4717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mi Casa Adult Living Facility Home, Inc
• Jennifer Lynn Miatech, MD
• Jeanette Micelotta, PT
• Michael a Chanatry DDS PA
• Michael a Parimucha MD LLC
• Michael D. Spencer, DDS, LLC
• Michael E Patch DDS PLLC
• Michael Jones DPT Atc CSCS LLC
• Michael L Middlebrooks DMD PA
• Michael R. Moore DDS PA

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.