Provider Demographics
NPI:1538379888
Name:CONLEY, DEBRA S (LCDP, LADCI, LSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:CONLEY
Suffix:
Gender:F
Credentials:LCDP, LADCI, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 FRANKLIN CLUB DR
Mailing Address - Street 2:UNIT 7204
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4662
Mailing Address - Country:US
Mailing Address - Phone:508-400-3338
Mailing Address - Fax:866-201-2279
Practice Address - Street 1:2020 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-2404
Practice Address - Country:US
Practice Address - Phone:401-781-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205627104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker