Provider Demographics
NPI:1235682428
Name:CONLEY, RANDEE
Entity Type:Individual
Prefix:
First Name:RANDEE
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RANDEE
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0790
Mailing Address - Country:US
Mailing Address - Phone:606-329-8588
Mailing Address - Fax:
Practice Address - Street 1:2901 PIGEON ROOST RD
Practice Address - Street 2:
Practice Address - City:RUSH
Practice Address - State:KY
Practice Address - Zip Code:41168-8132
Practice Address - Country:US
Practice Address - Phone:606-928-6648
Practice Address - Fax:606-928-1056
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY260635101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor