Connolly, Lisa Lynn

Connolly, Lisa Lynn is an sole proprietor health care provider with primary practice located at 3112 S Fairington Dr , Bloomington IN 47403-3914. 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, Lisa Lynn can be contacted via phone (812) 333-6536.

Contact Information

Primary practice address
3112 S Fairington Dr Bloomington IN 47403-3914
Phone: (812) 333-6536
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 39001380A Indiana

Profile Details

NPI number 1558333237
LBN Legal business name Connolly, Lisa Lynn
Credentials M.ED., LMHC, RBC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558333237 NPPES
Indiana Other 000000512064 ANTHEM
Indiana Other 11607950 ANTHEM

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