Provider Demographics
NPI:1386875425
Name:CONLEE, HOLLY ANN (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:CONLEE
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 NE 5TH LN
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-8137
Mailing Address - Country:US
Mailing Address - Phone:319-601-9838
Mailing Address - Fax:
Practice Address - Street 1:3408 WOODLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6504
Practice Address - Country:US
Practice Address - Phone:515-528-7856
Practice Address - Fax:515-528-7866
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0715802Medicaid