Provider Demographics
NPI:1235404930
Name:CONNELL, MELANIE ANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANNE
Last Name:CONNELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:ANNE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:741 W. 45TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601
Mailing Address - Country:US
Mailing Address - Phone:307-797-4827
Mailing Address - Fax:888-659-0934
Practice Address - Street 1:800 WERNER CT.
Practice Address - Street 2:SUITE 300
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601
Practice Address - Country:US
Practice Address - Phone:307-797-4827
Practice Address - Fax:888-659-0934
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1259101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY139464900Medicaid