Provider Demographics
NPI:1306991260
Name:CONLEY, D'ARCY MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:D'ARCY
Middle Name:MARIE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N COOPER ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61606-1058
Mailing Address - Country:US
Mailing Address - Phone:309-672-0949
Mailing Address - Fax:
Practice Address - Street 1:3020 W WILLOW KNOLLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8127
Practice Address - Country:US
Practice Address - Phone:309-681-5652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health