Michael Charles Connolly, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH4717 Issued in FL

Practice address

3947 Salisbury Rd
Jacksonville, FL 32216-6115

Phone

(904) 234-7803

Fax

(904) 899-8759

NPI assigned

Apr 9, 2007

Last updated

Jul 8, 2007By 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

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  Medicare reassignment Care Compare group
• Michael C Connolly

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1437519352
  NPD (past) Authorized official
• Rhodium Care Group Florida PA

  • Clinical Psychologist
  • Lakewood, NJ
  • NPI 1174235972
  NPD
• Beaches Recovery Services LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1538562319
  NPD (past)
• Tides Edge Recovery Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Jacksonville Beach, FL
  • NPI 1568985406
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952424616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PIPER PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594320",
            "telephone_number": "904-287-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 SALISBURY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166115",
            "telephone_number": "904-234-7803",
            "fax_number": "904-899-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Little Conner, PA-C
• Cheyenne Conner
• Patrice Conner
• Ann Harouny Connery
• Ann-Marie Colleen Connolly, OD
• Rachel Lauren Connolly
• Thomas J Connolly, MD/
• Lori Connon, MA-CCC/SLP
• Andrea Connor
• Eideann Marie Connor, DPT

• 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.