Active NPI
Nicole Connelly
- School Psychologist
- Monroe, NY
National Provider Identifier
1447095492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 3031494
- Practice address
- 91 Lakes Rd Ste 3
Monroe, NY 10950-2694 - Phone
- (845) 827-6227
- NPI assigned
- Jun 29, 2024
- Last updated
- Jun 29, 2024
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 3031494 | NY | Primary |
Addresses
Primary practice location
91 Lakes Rd Ste 3
Monroe, NY 10950-2694
Mailing address
91 Lakes Rd Ste 3
Monroe, NY 10950-2694
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 |
|---|---|---|---|
| 3031494 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719619200000",
"number": "1447095492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 LAKES RD STE 3",
"city": "MONROE",
"state": "NY",
"postal_code": "109502694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 LAKES RD STE 3",
"city": "MONROE",
"state": "NY",
"postal_code": "109502694",
"telephone_number": "845-827-6227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-29",
"last_updated": "2024-06-29",
"certification_date": "2024-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "3031494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.