MEDICARE: CHRISTOPHER MICHAEL CONLEY LMHC/LPCC

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
1	101YM0800X	Mental Health Counselor	16547	CA
2	101YM0800X	Mental Health Counselor	014408	NY

General Provider Information

NPI Number	:	1619726346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MICHAEL CONLEY LMHC/LPCC

Provider Business Mailing Address
First Line	:	390 HAUSER BLVD APT 5F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-5511
Country	:	US
Telephone Number	:	808-628-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 HAUSER BLVD APT 5F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-5511
Country	:	US
Telephone Number	:	808-628-1626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2024
Last Update Date	:	05/15/2024

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