MEDICARE: MS. ERIN MICHELLE CONNELL

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
1	101YP2500X	Professional Counselor	CP6076	NV

General Provider Information

NPI Number	:	1568720944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN MICHELLE CONNELL

Provider Business Mailing Address
First Line	:	6730 S FORT APACHE RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5396
Country	:	US
Telephone Number	:	702-665-5593
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 GRANITE RAPIDS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-7529
Country	:	US
Telephone Number	:	702-505-1774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	01/20/2026

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