Provider Demographics
NPI:1144766593
Name:CONLEY, CASSANDRA J (LPC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:J
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S EDWIN MOSES BLVD
Mailing Address - Street 2:4TH FLOOR NW BUILDING
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-734-8333
Mailing Address - Fax:937-342-4242
Practice Address - Street 1:601 S EDWIN MOSES BLVD
Practice Address - Street 2:4TH FLOOR NW BUILDING
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-8333
Practice Address - Fax:937-342-4242
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400134101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional