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General NPI Number Information
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NPI Number | 1356393052
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Entity Type | Individual
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Provider Name | KARIN CONNELLY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 9 AVA MARIA DR
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City | PHOENICIA
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State | NY
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Zip | 12464-5102
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Country | US
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Telephone | 845-750-0476
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 204
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City | FRANKLINVILLE
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State | NC
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Zip | 27248-0204
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Country | US
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Telephone | 845-750-0476
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Fax |
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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 | 3063
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012496
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License Number State | NY
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