DR. JOHN T CONNELLY JR. (NPI# 1710149042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710149042 |
| Entity Type | Individual |
| Full Name | DR. JOHN T CONNELLY JR. |
| Credential | PH.D.LPC.LRC |
| Practice Address |
6500 Madison Ave Suite 5b Pennsauken NJ 08109-2766 |
| Practice Telephone | 8564886285 |
| Practice Fax Number | 8566634743 |
| Mailing Telephone | 8564886285 |
| Mailing Fax Number | 8566634743 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-07-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PC912,RC1012 | NJ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023672375 | John Connelly | Social Worker | 22 Arrowhead Dr, West Simsbury, CT 06092-2800 | 2019-04-23 |
| 1972505071 | John W. Connelly | Dentist | 270 N Main St, Clintonville, WI 54929-1104 | 2005-06-02 |
| 1659873305 | John Michael Connelly | Military Health Care Provider | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-7000 | 2018-03-07 |
| 1124442165 | John Connelly | Counselor | 1949 Se 122nd Ave, Portland, OR 97233-1303 | 2014-02-11 |
| 1689000325 | John Thomas Connelly | Occupational Therapist | 4161 Tamiami Trl, Ste 103, Port Charlotte, FL 33952-9204 | 2013-09-25 |
| 1164866646 | John Thomas Connelly IIi | Physician Assistant | 1150 N. 35th Avenue, Suite 490, Hollywood, FL 33021 | 2013-04-26 |
| 1184705808 | John Coleman Connelly | Psychiatry & Neurology | 2100 Comer Ave, Columbus, GA 31904 | 2006-10-18 |
| 1245292432 | John Henry Connelly | Pathology | 6720 Bertner Ave, Houston, TX 77030 | 2006-04-04 |
| 1013982867 | John E Connelly | Family Medicine | 501 N 17th St, Suite # 108, Allentown, PA 18104-5044 | 2006-02-22 |
| Street Address |
6500 MADISON AVE SUITE 5B |
| City | PENNSAUKEN |
| State | NJ |
| Zip Code | 08109-2766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568898997 | Dean A Newton Pa | Family Medicine | 6500 Madison Ave, Suite Y, Pennsauken, NJ 08109-2766 | 2013-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730615543 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8301 Maple Ave, Pennsauken, NJ 08109 | 2017-05-11 |
| 1588085237 | Annie Nicole Fisher | Social Worker | 21 Merwit Court, Merchantville, NJ 08109 | 2013-12-26 |
| 1992013437 | Reliable Resources LLC | In Home Supportive Care | 211 West End Ave, Merchantville, NJ 08109 | 2010-09-17 |
| 1184942351 | Matt Lobel | Pharmacist | 14 South Cenre Street, Merchantville, NJ 08109 | 2010-05-12 |
| 1063662187 | Life At Lourdes Inc | PACE Provider Organization | 2475 Mcclellan Avenue, Pennsauken, NJ 08109 | 2008-09-25 |
| 1376712786 | Pinnacle Treatment Centers Nj IIi LLC | Clinic/Center | 7980 S Crescent Boulevard, Pennsauken, NJ 08109 | 2008-02-29 |
| 1043488851 | Karen Claytor | Physical Therapist | 2626 Mandall Ave, Pennsauken, NJ 08109 | 2008-02-14 |
| 1235334814 | Marian W Mote | Nurse Practitioner | Merchantville Pediatrics- A Division of Cha, 1 S. Centre Street, Suite 100, Merchantville, NJ 08109 | 2007-06-15 |
| 1386865905 | Enrico Doganiero | Pharmacist | 6338 Browning Rd, Pennsauken, NJ 08109 | 2007-05-01 |
| 1710008164 | Michele Jo Hain | Physical Therapist | 6981 N Park Drive, Suite 102, Pennsaukin, NJ 08109 | 2007-04-03 |
| Find all providers in zip 08109 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073139259 | Paul Lehrer Phd, LLC | Psychologist | 4105 Us Highway 1 Ste 11, Monmouth Junction, NJ 08852-2157 | 2020-06-23 |
| 1316560857 | Stephanie M Poe-cerdan | Psychologist | 622 Franklin Rd, Wenonah, NJ 08090-1230 | 2020-05-19 |
| 1508348863 | Gerald D Mingin Jr. | Psychologist | 135 Eayrestown Rd. Suite A, Southampton, NJ 08055 | 2018-09-04 |
| 1639614308 | Lauren Michelle Foran | Psychologist | 3575 Quakerbridge Road, Hamilton, NJ 08619 | 2017-01-04 |
| 1326401969 | Denise Wallack | Psychologist | 470 Forest St, Unit 2, Kearny, NJ 07032-3582 | 2016-03-31 |
| 1205292190 | Karen Nancy Wasserman | Psychologist | 12 Vista Ter, Livingston, NJ 07039-1915 | 2016-01-07 |
| 1831582170 | Anton Shcherbakov | Psychologist | 1910 Route 70 E Ste 5&7, Cherry Hill, NJ 08003-2123 | 2015-03-11 |
| 1962742189 | Therapeutic Outreach for Children, Inc | Psychologist | 1 Farm Ln # 458, Roosevelt, NJ 08555-9800 | 2013-02-25 |
| 1235496332 | Sandra Singer | Psychologist | 7 S Main St Ste B, Marlboro, NJ 07746-1578 | 2012-04-13 |
| 1891922738 | Alana Miriam Balaban Fisher | Psychologist | 764 Palisade Ave Ste 1f, Teaneck, NJ 07666-3129 | 2009-06-18 |
| Find all providers with the same taxonomy | ||||
| City | PENNSAUKEN |
| Zip Code | 08109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.