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NPI Code Detail

MEDICARE: D'ARCY MARIE CONLEY LCPC

MEDICARE:   D'ARCY MARIE CONLEY  LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorIL

General Provider Information

NPI Number : 1306991260
Entity Type Code : Individual
Provider Name (Legal Business Name) : D'ARCY MARIE CONLEY LCPC
Provider Business Mailing Address
First Line : 820 N COOPER ST
Second Line :
City : PEORIA
State : IL
Zip : 61606-1058
Country : US
Telephone Number : 309-672-0949
Fax Number :
Provider Business Practice Location Address
First Line : 3020 W WILLOW KNOLLS DR
Second Line :
City : PEORIA
State : IL
Zip : 61614-8127
Country : US
Telephone Number : 309-681-5652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 07/08/2007

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Directions to “ D'ARCY MARIE CONLEY LCPC” Practice Location

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