Healthcare Provider Details

I. General information

NPI: 1538379888
Provider Name (Legal Business Name): DEBRA S CONLEY LCDP, LADCI, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 ELMWOOD AVE
WARWICK RI
02888-2404
US

IV. Provider business mailing address

319 FRANKLIN CLUB DR UNIT 7204
DELRAY BEACH FL
33483-4662
US

V. Phone/Fax

Practice location:
  • Phone: 401-781-2700
  • Fax:
Mailing address:
  • Phone: 508-400-3338
  • Fax: 866-201-2279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number205627
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: