Amy Connelly, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401012166 Issued in MI

Practice address

44444 Hayes Rd
Clinton Township, MI 48038-7600

Phone

(248) 766-8977

NPI assigned

Oct 3, 2011

Sex

Female

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

State licenses

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1871877399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 NORTHWOOD AVE",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071542",
            "telephone_number": "248-766-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44444 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480387600",
            "telephone_number": "248-766-8977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Northwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MI",
            "postal_code": "483071542",
            "country_code": "US",
            "telephone_number": "248-766-8977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "AMY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401012166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Convergence Counseling and Consulting, LLC

• Counselor in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.