Basic Information
| Provider Information | |||||||||
| NPI: | 1851355945 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONELL | ||||||||
| FirstName: | LAWRENCE | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405647007 | ||||||||
| FaxNumber: | 5405647038 | ||||||||
| Practice Location | |||||||||
| Address1: | 644 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228013750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405647007 | ||||||||
| FaxNumber: | 5405647038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 09/17/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 0101033110 | VA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 1000870001 | 01 | VA | DME PROVIDER | OTHER | 49119000 | 01 | MAGELLAN | OTHER | 7110464 | 05 | VA | MEDICAID | 178633 | 01 | COM PSYCH | OTHER | 18761 | 01 | CIGNA BEHAVIORAL HEALTH | OTHER | 260039340 | 01 | RAILROAD MEDICARE | OTHER | O88283 | 01 | SENTARA | OTHER | 012441 | 01 | VALUE OPTIONS | OTHER | 7100050000 | 01 | WV | WV MEDICAID | OTHER | 88283 | 01 | VA | OPTIMA | OTHER | 264430 | 01 | ANTHEM/BCBS | OTHER |