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NPI Code Detail

MEDICARE: CONNIE REILLY

MEDICARE: CONNIE REILLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor103438CA
2104100000XSocial Worker136702CA
3101Y00000XCounselor

General Provider Information

NPI Number : 1841967312
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE REILLY
Provider Business Mailing Address
First Line : 2719 N AIR FRESNO DR
Second Line :
City : FRESNO
State : CA
Zip : 93727-1547
Country : US
Telephone Number : 559-600-6743
Fax Number :
Provider Business Practice Location Address
First Line : 2719 N AIR FRESNO DR
Second Line :
City : FRESNO
State : CA
Zip : 93727-1547
Country : US
Telephone Number : 559-600-6743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2021
Last Update Date : 03/04/2026

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Directions to “ CONNIE REILLY ” Practice Location

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