Provider Demographics
NPI:1164762266
Name:CONLEY, MICHAEL ANNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MICHAEL ANNE
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0424
Mailing Address - Country:US
Mailing Address - Phone:925-262-4848
Mailing Address - Fax:925-284-7163
Practice Address - Street 1:953 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3729
Practice Address - Country:US
Practice Address - Phone:925-262-4848
Practice Address - Fax:925-284-7163
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28865106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist