MRS. AMY MICHELLE CONNOLLY LPC
NPI 1023066214
Counselor - Professional in Portland, OR

Active since May 04, 2006Opted out of Medicare · through Feb 16, 2028
4300 NE FREMONT ST STE 260, PORTLAND, OR 97213(503) 866-3971 Get Directions Write a Review

NPPES record last updated: August 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Amy Michelle Connolly Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. AMY MICHELLE CONNOLLY LPC (NPI 1023066214) is an individual professional provider in Portland, Oregon, licensed in Oregon (C1676) and active in the NPI registry since May 2006. She has opted out of Medicare through February 16, 2028.

NPPES Registry Identity

NPI1023066214
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. AMY MICHELLE CONNOLLYCredential: LPC
Location Address4300 NE FREMONT ST STE 260Portland, OR 97213-1100
Mailing Address4300 Ne Fremont St Ste 260Portland, OR 97213-1100 · (503) 866-3971
Sole ProprietorYes
Enumeration DateMay 4, 2006
Last NPPES UpdateAugust 10, 2022
NPPES CertifiedAugust 10, 2022
NPI 1023066214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in OR · C1676
4300 NE FREMONT ST STE 260, Portland, OR 97213

Other Names 1

Former Name (1)Ms. Amy Michelle Cannon Lpc

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Mrs. Amy Michelle Connolly Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 16, 2026 through February 16, 2028.

Opt-Out Effective DateFebruary 16, 2026
Opt-Out In Effect ThroughFebruary 16, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
4300 NE FREMONT ST STE 260
PORTLAND, OR 97213
Counselor (Mental Health)
4300 NE FREMONT ST STE 260
PORTLAND, OR 97213
Counselor (Professional)
4300 NE FREMONT ST STE 260
PORTLAND, OR 97213
Nurse Practitioner (Psychiatric/Mental Health)
4300 NE FREMONT ST STE 260
PORTLAND, OR 97213
Nurse Practitioner (Psychiatric/Mental Health)
4300 NE FREMONT ST STE 260
PORTLAND, OR 97213
Marriage & Family Therapist
4300 NE FREMONT ST STE 260, STE 260
PORTLAND, OR 97213

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Connolly's NPI number?

The NPI number for Amy Connolly is 1023066214. It was assigned to this individual provider in the NPPES registry on May 4, 2006. The provider is also known as Ms. Amy Michelle Cannon Lpc.

Where is Amy Connolly located?

Amy Connolly practices at 4300 NE Fremont St Ste 260, Portland, OR 97213. The listed phone number is (503) 866-3971.

What is Amy Connolly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Amy Connolly enrolled in Medicare?

No. Amy Connolly has opted out of Medicare through February 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Amy Connolly accept?

Health plans from PacificSource Health Plans list Amy Connolly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amy Connolly was last updated on August 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.