Sean Michael Connolly, B.S

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

140 South Holly Street
Medford, OR 97501

Phone

(541) 774-8200

Fax

(541) 774-7964

NPI assigned

Dec 22, 2011

Last updated

Dec 11, 2014By 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)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1821367624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SOUTH HOLLY STREET",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-774-8200",
            "fax_number": "541-774-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SOUTH HOLLY STREET",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-774-8200",
            "fax_number": "541-774-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "credential": "B.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Kathleen Connell
• Caroline L Connelly, FNP
• John Liam Connelly, NCC
• Denise Conner, RN
• Shara Ann Conner
• Lawrence Christopher Conover, PAC
• Jody Lee Conrad
• Conscious Life Counseling, LLC
• Amanda Louise Constable, QMHA
• Gregory E Conway, MD

• Psychologist in Medford, OR
• Providers in Medford, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.