JENNIFER CONNOLLY LADC
NPI 1578288403
Counselor - Addiction (Substance Use Disorder) in Coon Rapids, MN
Active since October 04, 2022
About Jennifer Connolly Ladc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER CONNOLLY LADC (NPI 1578288403) is an individual addiction (substance use disorder) provider in Coon Rapids, Minnesota, licensed in Minnesota (305835) and active in the NPI registry since October 2022.
NPPES Registry Identity
NPI1578288403
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJENNIFER CONNOLLYCredential: LADC
Location Address11660 ROUND LAKE BLVD NWCoon Rapids, MN 55433-2638
Mailing Address11452 Kenyon Ct NeBlaine, MN 55449-5480 · (612) 272-7953
Phone(763) 767-3350
Sole ProprietorNo
Enumeration DateOctober 4, 2022
NPPES CertifiedOctober 4, 2022
✔ NPI 1578288403 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MN · 305835
11660 ROUND LAKE BLVD NW, Coon Rapids, MN 55433
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Addiction (Substance Use Disorder))
11660 ROUND LAKE BLVD NW
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578288403, enumerated as an "individual" on October 04, 2022.
The provider is located at 11660 ROUND LAKE BLVD NW COON RAPIDS, MN 55433 and the phone number is (763) 767-3350.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
