Healthcare Provider Details

I. General information

NPI: 1942076088
Provider Name (Legal Business Name): DANNICA CONLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20955 PROFESSIONAL PLZ STE 310
ASHBURN VA
20147-3405
US

IV. Provider business mailing address

165 IRIS DR
MARTINSBURG WV
25404-1340
US

V. Phone/Fax

Practice location:
  • Phone: 703-942-9745
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701013947
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: