Connelly, James William

Connelly, James William is an individual health care provider with primary practice located at 2076 S Eagle Rd , Meridian ID 83642-6707. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Connelly, James William can be contacted via phone (208) 955-7333.

Contact Information

Primary practice address
2076 S Eagle Rd Meridian ID 83642-6707
Phone: (208) 955-7333
Fax: (208) 955-7330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 202425 Idaho

Profile Details

NPI number 1841324332
LBN Legal business name Connelly, James William
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2007
Last updated Apr 30th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841324332 NPPES
Idaho MEDICAID 002269500

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