Healthcare Provider Details

I. General information

NPI: 1538044680
Provider Name (Legal Business Name): CONLEY PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 LAKE PT
WESTERVILLE OH
43082-7484
US

IV. Provider business mailing address

1131 LAKE PT
WESTERVILLE OH
43082-7484
US

V. Phone/Fax

Practice location:
  • Phone: 614-949-6842
  • Fax:
Mailing address:
  • Phone: 614-949-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HALEY JO CONLEY
Title or Position: OWNER
Credential: APRN-CNP, PMHNP
Phone: 614-949-6842