Individual provider · Type 1 NPI

Kevin Connolly

Professional Counselor · Bloomingdale, IL

NPI number 1124419643 Active

Practice location

1 Tiffany Pt Ste 110
Bloomingdale, IL 60108-2915

Mailing address

1617 Lake Ave
Wilmette, IL 60091-1535

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X180009277 (IL)
Addiction (Substance Use Disorder) Counselor 101YA0400X180009277 (IL)
Mental Health Counselor 101YM0800X180009277 (IL)
Marriage & Family Therapist 106H00000X180009277 (IL)

Professional Counselor: Definition to come...

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About NPI 1124419643

Kevin Connolly's National Provider Identifier is 1124419643, issued on Feb 6, 2015. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bloomingdale, IL. The record was last updated on Feb 12, 2015.