Healthcare Provider Details

I. General information

NPI: 1114376316
Provider Name (Legal Business Name): CHELSEA CONROY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23100 JEFFERSON AVE
SAINT CLAIR SHORES MI
48080-2756
US

IV. Provider business mailing address

6549 TOWN CENTER DR SUITE A
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 586-335-2006
  • Fax: 586-279-3886
Mailing address:
  • Phone: 248-620-6400
  • Fax: 248-620-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801099601
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: