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Organization
MICHAEL C CONNOLLY
Active
Organization
MICHAEL C CONNOLLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CONNOLLY LMHC (LICENSED CLINICIAN)
(904) 234-7803
Entity
Organization
Contact information
Practice address
8825 PERIMETER PARK BLVD STE 602, JACKSONVILLE, FL 32216-1122
(904) 234-7803
Mailing address
412 PIPER PL, SAINT JOHNS, FL 32259-4320
(904) 234-7803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 4717
FL
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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