Active NPI
Theresa A Conley, LAC, MSW
- Addiction (Substance Use Disorder) Counselor
- Missoula, MT
National Provider Identifier
1669808887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1405
- Practice address
- 1325 Wyoming St
Missoula, MT 59801-1725 - Phone
- (406) 532-9800
- Fax
- (406) 541-3032
- NPI assigned
- Sep 19, 2013
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1405 | MT | Primary |
Addresses
Primary practice location
1325 Wyoming St
Missoula, MT 59801-1725
Mailing address
3255 LT Moss Rd
Missoula, MT 59804-7220
Phone (406) 532-8409
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1405 | MT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1669808887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3255 LT MOSS RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047220",
"telephone_number": "406-532-8409",
"fax_number": "406-543-9316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 WYOMING ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598011725",
"telephone_number": "406-532-9800",
"fax_number": "406-541-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "THERESA",
"middle_name": "A",
"credential": "LAC, MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-19",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "1405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.