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General NPI Number Information
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NPI Number | 1013061761
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Entity Type | Individual
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Provider Name | CATHERINE ANNE MCCONNELL PHD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 625 57TH ST STE 502
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City | KENOSHA
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State | WI
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Zip | 53140-4146
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Country | US
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Telephone | 262-419-2277
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Fax | 920-215-6164
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Provider Business Mailing Address
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Address Line | 325 N COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-2665
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Country | US
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Telephone | 262-419-2277
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Fax | 920-215-6164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071006290
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2336
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License Number State | WI
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