Provider Demographics
NPI:1851453146
Name:CONLEY, CHRISTOPHER (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CONLEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 WAYZATA BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1301
Mailing Address - Country:US
Mailing Address - Phone:952-544-6806
Mailing Address - Fax:
Practice Address - Street 1:5219 WAYZATA BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1301
Practice Address - Country:US
Practice Address - Phone:952-544-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP37598OtherHEALTH PARTNERS
MNMEDICAOtherMEDICA
MN300G4COOtherBCBS
FM126913OtherUCARE