Provider Demographics
NPI:1750093464
Name:CONLEY, MEGAN FAITH (BSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:FAITH
Last Name:CONLEY
Suffix:
Gender:F
Credentials:BSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1053
Mailing Address - Country:US
Mailing Address - Phone:740-935-4673
Mailing Address - Fax:
Practice Address - Street 1:14590 STATE ROUTE 93
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-8977
Practice Address - Country:US
Practice Address - Phone:740-286-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208517104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty