Connolly, Bonnie L
Connolly, Bonnie L is an individual health care provider with primary practice located at 1 1/2 W Geneva St Credence Therapy Associates, Elkhorn WI 53121-1722. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Connolly, Bonnie L can be contacted via phone (262) 723-3424.Contact Information
Primary practice address
1 1/2 W Geneva St Credence Therapy Associates
Elkhorn WI 53121-1722
Phone: (262) 723-3424
Fax: (262) 723-8308
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LI2718125 | Wisconsin |
Profile Details
| NPI number | 1043204563 |
|---|---|
| LBN Legal business name | Connolly, Bonnie L |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1043204563 | NPPES |
| Wisconsin | Other | 39799400 | HIRSP |
| Wisconsin | Other | 1059860 | HIRSP |
| Wisconsin | Other | 39799400 | HIRSP |
| Wisconsin | Other | 13042 | HIRSP |
| Wisconsin | MEDICAID | 39799400 | HIRSP |
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