Active NPI
Jordan Danielle Conley, LPC
- Professional Counselor
- Johnson City, TN
National Provider Identifier
1659930543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3991
- Practice address
- 2408 Susannah St Ste 1
Johnson City, TN 37601-1765 - Phone
- (423) 434-6677
- Fax
- (423) 461-0000
- NPI assigned
- Jun 13, 2019
- Last updated
- Jan 17, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3991 | TN | Primary |
Addresses
Primary practice location
2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Mailing address
2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone (423) 434-6677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3991 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1659930543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 SUSANNAH ST STE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011765",
"telephone_number": "423-434-6677",
"fax_number": "423-461-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 SUSANNAH ST STE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011765",
"telephone_number": "423-434-6677",
"fax_number": "423-461-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "JORDAN",
"middle_name": "DANIELLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "3991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.