Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Connolly, LICSW

Individual provider Clinical Social Worker · NPI 1487381091

Kelly Connolly, LICSW is a Clinical Social Worker in Coon Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2022.

Licensed in
MN
In the registry since
2022
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

3960 Coon Rapids Blvd NW Ste 200
Coon Rapids, MN 55433-2589
Phone: (763) 236-9236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 25205 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 25205 (MN)

Record details

NPI number1487381091
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedAugust 3, 2022
Last updated in NPPESJanuary 17, 2023
Certification dateJanuary 17, 2023

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