Jessica Ellen Conway, MA, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0171001384 Issued in VA

Practice address

1409 Grandin Rd SW
Roanoke, VA 24015-2317

Phone

(703) 899-2983

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1417092214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 LANSING DR SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153928",
            "telephone_number": "703-899-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 GRANDIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152317",
            "telephone_number": "703-899-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JESSICA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46463",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001384",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0171001384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Ranee Conrad, PA-C
• Ashlyn Brooke Conrad
• John C. Conrad, M.D.
• John Christian Conrad Jr., P.A.
• Andrea Rose Conti, D.O.
• Benjamin Ray Coobs, MD
• Bethany Cook, L.C.S.W.
• Callie Mikala Cook
• Cathleen Marie Cook, M.D.
• Haley Rebecca Cook

• Mental Health Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.