Provider Demographics
NPI:1437328440
Name:CONLEY, MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CONLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 WHISPERING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-3714
Mailing Address - Country:US
Mailing Address - Phone:336-996-4390
Mailing Address - Fax:336-996-1076
Practice Address - Street 1:5804 WHISPERING MEADOW LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-3714
Practice Address - Country:US
Practice Address - Phone:336-996-4390
Practice Address - Fax:336-996-1076
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-23
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2453103T00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No251S00000XAgenciesCommunity/Behavioral Health