| Kelly Connell Counseling Llc | |
|
15 Kathay Dr Livingston NJ 07039-4711 | |
| (201) 543-7651 | |
| Not Available |
| Full Name | Kelly Connell Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 15 Kathay Dr, Livingston, New Jersey |
| Authorized Official Name and Position | Kelly Connell (INCORPORATOR) |
| Authorized Official Contact | 9735676886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Connell Counseling Llc Po Box 652 Livingston NJ 07039-0652 Ph: (973) 567-6886 | Kelly Connell Counseling Llc 15 Kathay Dr Livingston NJ 07039-4711 Ph: (201) 543-7651 |
| NPI Number | 1710417340 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 04/21/2022 |
| Certification Date | 04/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710417340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00589400 (New Jersey) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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