Individual
SUZANNE MAE CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW MSW
Contact information
Practice address
70 PAYNE PLACE, SUITE 6, SEDONA, AZ 86336-4536
(928) 282-2627
(928) 282-0121
Mailing address
70 PAYNE PLACE, SUITE 6, SEDONA, AZ 86336-4536
(928) 282-2627
(928) 282-0121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC0022
AZ
101YM0800X
Mental Health Counselor
LCSW-1454
AZ
106H00000X
Marriage & Family Therapist
LMFT0145
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-1454
STATE LICENSE
AZ
01
—
LISAC-0022
STATE LICENSURE
AZ
01
—
LMFT-0145
STATE LICENSE
AZ
Enumeration date
08/19/2006
Last updated
07/13/2016
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