KATHLEEN CONNELLY LAC
NPI 1073251609
Counselor - Professional in Evesham, NJ
About Kathleen Connelly Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHLEEN CONNELLY LAC (NPI 1073251609) is an individual professional provider in Evesham, New Jersey, licensed in New Jersey (37PC01136900) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kathleen Connelly Lac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARLTON, NJ 08053
MARLTON, NJ 08053
MARLTON, NJ 08053
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 Kathleen Connelly's NPI number?
The NPI number for Kathleen Connelly is 1073251609. It was assigned to this individual provider in the NPPES registry on May 24, 2022.
Where is Kathleen Connelly located?
Kathleen Connelly practices at 105 Evesboro Medford Rd, Evesham, NJ 08053. The listed phone number is (609) 948-4995.
What is Kathleen Connelly's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kathleen Connelly enrolled in Medicare?
Yes. Kathleen Connelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Kathleen Connelly was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Kathleen Connelly, LAC · NPI 1073251609
Professional provider in Evesham, New Jersey. Individual provider, active in the CMS NPPES registry since May 24, 2022.
## Identity
- **NPI:** 1073251609 (Entity type: Individual)
- **Enumerated:** May 24, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 37PC01136900 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 105 EVESBORO MEDFORD RD, Evesham, NJ 08053-3865
- **Phone:** (609) 948-4995
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** October 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1073251609) · Data from the CMS NPPES public registry.