Provider Demographics
NPI:1124743364
Name:CONNOLLY, SHEILA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6262 RIVERWALK LN UNIT 1
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7992
Mailing Address - Country:US
Mailing Address - Phone:561-234-8415
Mailing Address - Fax:
Practice Address - Street 1:6262 RIVERWALK LN UNIT 1
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7992
Practice Address - Country:US
Practice Address - Phone:561-234-8415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21043101YM0800X
COLPC.0021279101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health