MRS. LISA LYNN CONNOLLY (NPI# 1558333237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558333237 |
Entity Type | Individual |
Full Name | MRS. LISA LYNN CONNOLLY |
Credential | M.ED., LMHC, RBC |
Practice Address |
3112 S Fairington Dr Bloomington IN 47403-3914 |
Practice Telephone | 8123336536 |
Mailing Telephone | 8123336536 |
Enumeration Date | 2006-02-06 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
39001380A | IN | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | CAQH # | 11607950 | 01 |
IN | ANTHEM | 000000512064 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144619628 | Lisa Maureen Connolly | Licensed Practical Nurse | 44 Chalone Dr W, Fulton, NY 13069-4219 | 2015-01-21 |
1124261268 | Lisa B. Connolly | Developmental Therapist | 2 Otis Cir, Brunswick, ME 04011-7399 | 2009-04-18 |
1356505697 | Lisa Ann Connolly | Physical Therapist | 7 Plaza Dr, Scarborough, ME 04074-8996 | 2008-07-16 |
1487677027 | Lisa Marie Connolly | Family Medicine | 6 Kimball Ln, Lahey Lynnfield, Lynnfield, MA 01940-2682 | 2006-07-25 |
1811273469 | Lisa Kristine Connolly | Speech-Language Pathologist | 500 River Ave, Suite 245, Lakewood, NJ 08701-4738 | 2011-10-27 |
1619009560 | Lisa Marie Connolly | Social Worker | 69 Alleghany St, Roxbury Crossing, MA 02120-3336 | 2007-03-09 |
Street Address |
3112 S FAIRINGTON DR |
City | BLOOMINGTON |
State | IN |
Zip Code | 47403-3914 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
Find all providers in zip 47403 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
1881218642 | Amy Lynn Hootman | Counselor | 2806 W Fawkesway Dr, Bloomington, IN 47404-1211 | 2020-06-07 |
1568096543 | Elm Services LLC | Counselor | 4076 N Brookwood Dr, Bloomington, IN 47404-9602 | 2020-02-27 |
1033759014 | Joseph Gerbofsky | Counselor | 410 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-01-08 |
1508416371 | Amy Michelle Owens | Counselor | 400 W 7th St Ste 105g, Bloomington, IN 47404-3900 | 2019-09-13 |
1407401714 | Nichole M Day | Counselor | 101 W Kirkwood Ave Ste 210, Bloomington, IN 47404-6133 | 2019-08-04 |
1548721574 | Ashley Hilkey | Counselor | 4500 W Woodland Dr, Bloomington, IN 47404-9582 | 2019-03-31 |
1235695867 | Sandra K. Tucker, Ms, Lmhc, LLC | Counselor | 822 W 1st St Ste 4, Bloomington, IN 47403-2382 | 2019-02-19 |
1487120903 | Rebecca Anne Romberger | Counselor | 530 W Center, Bloomington, IL 61701-6170 | 2018-10-23 |
1740789635 | Jonna Marie Capio Lmhc LLC | Counselor | 3925 E Hagan St Ste 307, Bloomington, IN 47401-8649 | 2018-02-06 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47403 |
Please comment or provide details below to improve the information on MRS. LISA LYNN CONNOLLY.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.