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:
Health care specialties
| Specialty | Code | License # | 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 13 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 | 1841324332 | NPPES |
| Idaho | MEDICAID | 002269500 |
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