Healthcare Provider Details
I. General information
NPI: 1881566487
Provider Name (Legal Business Name): DEIRDRE CONROY PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5777 W MAPLE RD STE 185
WEST BLOOMFIELD MI
48322-2268
US
IV. Provider business mailing address
397 E BRECKENRIDGE ST # 104
FERNDALE MI
48220-1321
US
V. Phone/Fax
- Phone: 313-241-6067
- Fax:
- Phone: 734-223-7148
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 173F00000X |
| Taxonomy | Sleep Specialist (PhD) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEIRDRE
CONROY
Title or Position: OWNER
Credential: PHD
Phone: 313-241-6067