Healthcare Provider Details

I. General information

NPI: 1912287863
Provider Name (Legal Business Name): EILEEN M CONWAY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EILEEN RIGDON PSYD

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 N CENTRAL AVE # 1821
PHOENIX AZ
85004-2185
US

IV. Provider business mailing address

PO BOX 1821
PHOENIX AZ
85001-1821
US

V. Phone/Fax

Practice location:
  • Phone: 623-252-1224
  • Fax:
Mailing address:
  • Phone: 623-332-1828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-005391
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4363642
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: