| Lillian Danelle Connelly, LCSW | |
|
315 E Elm St Ste 201, Caldwell, ID 83605-4857 | |
| (208) 514-2528 | |
| (208) 375-2217 |
| Full Name | Lillian Danelle Connelly |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 315 E Elm St Ste 201, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457881989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-39183 (Idaho) | Primary |
| Entity Name | Full Circle Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841490075 PECOS PAC ID: 6709986797 Enrollment ID: O20070924000618 |
| Mailing Address | Practice Location Address |
|---|---|
| Lillian Danelle Connelly, LCSW 777 N Raymond St, Boise, ID 83704-9251 Ph: (208) 514-2500 | Lillian Danelle Connelly, LCSW 315 E Elm St Ste 201, Caldwell, ID 83605-4857 Ph: (208) 514-2528 |
Mary Kay Gordon-brunner, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 314 Badiola St, Caldwell, ID 83605 Phone: 702-589-4871 | |
Mrs. Kristina Marie Pugh, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13802 Quintessa St, Caldwell, ID 83607 Phone: 801-599-7123 | |
Tara Byrne, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-608-8839 | |
Mrs. Amanda Kay Goldston, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-455-7045 Fax: 208-454-7714 | |
Judy Ann Hudson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 23057 Old Highway 30, Caldwell, ID 83607 Phone: 208-860-2345 Fax: 208-459-6921 | |
Ms. Asha Sharp, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-455-7033 Fax: 208-454-7714 | |
Jason Johnson, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2609 S 10th Ave Ste 102, Caldwell, ID 83605 Phone: 208-454-2766 |