Healthcare Provider Details

I. General information

NPI: 1891678512
Provider Name (Legal Business Name): CONRAD COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 17TH ST
DENVER CO
80202-5402
US

IV. Provider business mailing address

4439 E CO. HIGHWAY
SANTA ROSA BEACH FL
32459
US

V. Phone/Fax

Practice location:
  • Phone: 808-740-3222
  • Fax:
Mailing address:
  • Phone: 808-740-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHASE CONRAD
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 808-740-3222