Provider Demographics
NPI:1316215841
Name:CONNELY, DONNA E (MA, LIMHP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:E
Last Name:CONNELY
Suffix:
Gender:F
Credentials:MA, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23125
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68542-3125
Mailing Address - Country:US
Mailing Address - Phone:402-601-3422
Mailing Address - Fax:
Practice Address - Street 1:5220 LEIGHTON AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504
Practice Address - Country:US
Practice Address - Phone:402-601-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1578102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1578OtherLIMHP