Provider Demographics
NPI:1912399353
Name:EILEEN C CONNELL LLC
Entity Type:Organization
Organization Name:EILEEN C CONNELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:913-515-1527
Mailing Address - Street 1:415 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3049
Mailing Address - Country:US
Mailing Address - Phone:913-515-1527
Mailing Address - Fax:
Practice Address - Street 1:9229 WARD PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3326
Practice Address - Country:US
Practice Address - Phone:913-515-1527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty