Provider Demographics
NPI:1750518833
Name:CONROY, DIANNE LEE (LPC)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:LEE
Last Name:CONROY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 ANGEL FIRE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2620
Mailing Address - Country:US
Mailing Address - Phone:214-725-1958
Mailing Address - Fax:
Practice Address - Street 1:2003 SE WALTON BLVD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3725
Practice Address - Country:US
Practice Address - Phone:479-725-6000
Practice Address - Fax:479-750-4843
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1901014101YP2500X
TX65298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health