Provider Demographics
NPI:1891110631
Name:CONLEY, MARGARET LADELL (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:LADELL
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24A FALCON CIR NW APT 316
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-7362
Mailing Address - Country:US
Mailing Address - Phone:470-494-4334
Mailing Address - Fax:
Practice Address - Street 1:2222 E WEST CONNECTOR
Practice Address - Street 2:APT 316
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8190
Practice Address - Country:US
Practice Address - Phone:678-577-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0053341041C0700X
GACSW0061121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty