Active NPI
Rena Conley, PH.D.
- Clinical Psychologist
- Wilton Manors, FL
National Provider Identifier
1033324397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY4294
- Practice address
- 1881 NE 26TH Street,
Suite 216
Wilton Manors, FL 33305-1400 - Phone
- (954) 727-9712
- Fax
- (954) 566-7671
- NPI assigned
- May 11, 2007
- Last updated
- May 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY4294 | FL | Primary |
Addresses
Primary practice location
1881 NE 26TH Street,
Suite 216
Wilton Manors, FL 33305-1400
Mailing address
1881 NE 26TH Street,
Suite 216
Wilton Manors, FL 33305-1400
Phone (954) 727-9712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1033324397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1881 NE 26TH STREET,",
"address_2": "SUITE 216",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333051400",
"telephone_number": "954-727-9712",
"fax_number": "954-566-7671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1881 NE 26TH STREET,",
"address_2": "SUITE 216",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333051400",
"telephone_number": "954-727-9712",
"fax_number": "954-566-7671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "RENA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY4294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilton Manors, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.