Provider Demographics
NPI:1043011380
Name:CONNELL, MAYA THAKE (LPC, PCD(DONA))
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:THAKE
Last Name:CONNELL
Suffix:
Gender:
Credentials:LPC, PCD(DONA)
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:THAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5020 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2807
Mailing Address - Country:US
Mailing Address - Phone:812-568-9821
Mailing Address - Fax:
Practice Address - Street 1:5020 14TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2807
Practice Address - Country:US
Practice Address - Phone:812-568-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula