Individual provider Active NPI

Mary Elizabeth Connolly, MA, LPC, NCC

  • Professional Counselor
  • Wheeling, WV
National Provider Identifier
1588318372
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2826 Issued in WV
Practice address
1100 Main Street
Wheeling, WV 26003
Phone
(304) 460-5123
NPI assigned
Feb 9, 2022
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 662 WV
Mental Health Counselor 101YM0800X 2826 WV
Professional Counselor 101YP2500X 2826 WV Primary

Addresses

Primary practice location

1100 Main Street
Wheeling, WV 26003

Mailing address

1100 Main Street
Wheeling, WV 26003
Phone (304) 460-5123

Other practice location 1

76 14th St
Wheeling, WV 26003-3429
Phone (715) 212-6993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105001558 WV Practitioner - Mental Health Counselor 0941657985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grandw IncGroup PAC ID 9739324922, 93 clinicians

Practice addresses (Care Compare)

1100 Main St
Suite 104
Wheeling, WV 26003-2737
Phone (304) 460-5123

76 -14TH St
Wheeling, WV 26003-3429
Phone (715) 212-6993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2826WVMDMental Health Counselor
662WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Connolly, Ma, LPC, NCC, LLC Mental Health CurrentSince Aug 25, 2024 Accepting new patients
GR&W, Inc CurrentSince Jan 1, 2024 Accepting new patients
GR&W, Inc PastSince Jan 1, 2024 Accepting new patients

Locations

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

1100 Main St
Ste 104
Wheeling, WV 26003
Phone (304) 218-9405

76 14th St
Wheeling, WV 26003
Phone (304) 280-5527

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1588318372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MAIN STREET",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-460-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MAIN STREET",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-460-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 14th St",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "260033429",
            "country_code": "US",
            "telephone_number": "715-212-6993",
            "fax_number": "304-905-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "662",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2826",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.