Individual
MR. WILLIAM T CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7629 KY ROUTE 979, GRETHEL, KY 41631-6304
(606) 587-2200
(606) 587-2203
Mailing address
1709 KY ROUTE 321, SUITE 3, PRESTONSBURG, KY 41653-9097
(606) 886-8546
(606) 886-8548
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
574
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100099340
—
KY
Enumeration date
03/03/2008
Last updated
08/03/2012
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