Provider Demographics
NPI:1164952123
Name:CONNELL, KELLY APPEL (MA/EDS, LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:APPEL
Last Name:CONNELL
Suffix:
Gender:F
Credentials:MA/EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KATHAY DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4711
Mailing Address - Country:US
Mailing Address - Phone:201-543-7651
Mailing Address - Fax:
Practice Address - Street 1:2 W NORTHFIELD RD STE 212
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3758
Practice Address - Country:US
Practice Address - Phone:973-567-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00589400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional