Provider Demographics
NPI:1245095793
Name:CONKLIN, JOY MILLER (MMFT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:MILLER
Last Name:CONKLIN
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 ROCKY FORK RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5527
Mailing Address - Country:US
Mailing Address - Phone:615-967-8810
Mailing Address - Fax:
Practice Address - Street 1:7003 CHADWICK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5232
Practice Address - Country:US
Practice Address - Phone:615-967-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2338101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor