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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 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 1891787255 NPPES
Other 61-00069 EVERCARE
Other 0486J EVERCARE
MEDICAID 6000586 EVERCARE

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