Provider Demographics
NPI:1437510336
Name:CONLEY, TOMIAH (LPCC-S NCC LICDC)
Entity Type:Individual
Prefix:
First Name:TOMIAH
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LPCC-S NCC LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 OWL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:OH
Mailing Address - Zip Code:45628-9024
Mailing Address - Country:US
Mailing Address - Phone:740-600-0838
Mailing Address - Fax:
Practice Address - Street 1:15 N PAINT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3175
Practice Address - Country:US
Practice Address - Phone:740-775-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.161378101YA0400X
OHC.0900436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)