Provider Demographics
NPI:1861673642
Name:CONLEY, MARCI LYNN (LCSW, CAP)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:LYNN
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LCSW, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5209
Mailing Address - Country:US
Mailing Address - Phone:307-321-3076
Mailing Address - Fax:
Practice Address - Street 1:1800 EDINBURGH ST STE 5
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-4506
Practice Address - Country:US
Practice Address - Phone:307-321-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYCAP-066101YA0400X, 171M00000X
171M00000X
WYLCSW-10451041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator