Individual provider Active NPI

Mark Conley, L.C.S.W.

  • Clinical Social Worker
  • North Hills, CA
National Provider Identifier
1649466707
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27709 Issued in CA
Practice address
15305 Rayen St
North Hills, CA 91343-5117
Phone
(818) 892-3423
NPI assigned
Sep 21, 2007
Last updated
Oct 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27709 CA Primary

Addresses

Primary practice location

15305 Rayen St
North Hills, CA 91343-5117

Mailing address

15305 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423

Other names 1

  • Mark Gordonconley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27709CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1649466707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "MARK",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "GORDONCONLEY",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.