Connell, Bryan Edward
Connell, Bryan Edward is an individual health care provider with primary practice located at 3020 Prosperity Church Rd Ste J, Charlotte NC 28269-8100. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Connell, Bryan Edward can be contacted via phone (704) 641-0273.Contact Information
Primary practice address
3020 Prosperity Church Rd Ste J
Charlotte NC 28269-8100
Phone: (704) 641-0273
Fax: (704) 625-9182
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1681 | North Carolina |
Profile Details
NPI number | 1891787255 |
---|---|
LBN Legal business name | Connell, Bryan Edward |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 22nd, 2005 |
Last updated | Jun 25th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1891787255 | NPPES |
Other | 61-00069 | EVERCARE | |
Other | 0486J | EVERCARE | |
MEDICAID | 6000586 | EVERCARE |
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