Provider Demographics
NPI:1902975816
Name:UNREIN-DULOHERY, CONNIE MAY (LSCSW, LCAC, SAP)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:MAY
Last Name:UNREIN-DULOHERY
Suffix:
Gender:F
Credentials:LSCSW, LCAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7259 244TH RD
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-5825
Mailing Address - Country:US
Mailing Address - Phone:620-442-0551
Mailing Address - Fax:
Practice Address - Street 1:7259 244TH RD
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-5825
Practice Address - Country:US
Practice Address - Phone:620-442-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW1513101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS104865OtherBLUE CROSS BLUE SHIELD
KS104865OtherBLUE CROSS BLUE SHIELD