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NPI Code Detail

MEDICARE: LORNA JEAN DAVIDSON-CONNELLY MED

MEDICARE: LORNA JEAN DAVIDSON-CONNELLY MED
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
1101YA0400XAddiction (Substance Use Disorder) Counselor86MA
2101YM0800XMental Health Counselor4208MA
3101YS0200XSchool Counselor354200MA

General Provider Information

NPI Number : 1427124346
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNA JEAN DAVIDSON-CONNELLY MED
Provider Business Mailing Address
First Line : 15 LEDGEWOOD RD
Second Line :
City : WAKEFIELD
State : MA
Zip : 01880-3526
Country : US
Telephone Number : 781-245-9369
Fax Number :
Provider Business Practice Location Address
First Line : 27 CONGRESS ST
Second Line : SUITE 105
City : SALEM
State : MA
Zip : 01970-7309
Country : US
Telephone Number : 978-740-1510
Fax Number : 781-935-7805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 09/11/2025

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Directions to “ LORNA JEAN DAVIDSON-CONNELLY MED” Practice Location

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