Provider Demographics
NPI:1528401320
Name:CONNOLLY, MARYKATE ELIZABETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARYKATE
Middle Name:ELIZABETH
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LOCUST CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3544
Mailing Address - Country:US
Mailing Address - Phone:860-906-6563
Mailing Address - Fax:
Practice Address - Street 1:14 KRISTYN DR
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4190
Practice Address - Country:US
Practice Address - Phone:860-906-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical