Active NPI
Jennifer Rebecca Conley, LISW
- Clinical Social Worker
- Coal Grove, OH
National Provider Identifier
1699019992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.1302248
- Practice address
- 225 Carlton Davidson LN
Coal Grove, OH 45638-2924 - Phone
- (740) 354-7702
- Fax
- (740) 353-1662
- NPI assigned
- Nov 27, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3677 | KY | |
| Clinical Social Worker | 1041C0700X | I.1302248 | OH | Primary |
| Clinical Social Worker | 1041C0700X | DP00944265 | WV |
Addresses
Primary practice location
225 Carlton Davidson LN
Coal Grove, OH 45638-2924
Mailing address
225 Carlton Davidson LN
Coal Grove, OH 45638-2924
Phone (740) 354-7702
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005355002 | Medicaid | WV | |
| 30610026 | Medicaid | KY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3677 | KY | MD | Clinical Social Worker |
| I.1302248 | OH | MD | Clinical Social Worker |
| DP00944265 | WV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1699019992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 CARLTON DAVIDSON LN",
"city": "COAL GROVE",
"state": "OH",
"postal_code": "456382924",
"telephone_number": "740-354-7702",
"fax_number": "740-353-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 CARLTON DAVIDSON LN",
"city": "COAL GROVE",
"state": "OH",
"postal_code": "456382924",
"telephone_number": "740-354-7702",
"fax_number": "740-353-1662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "JENNIFER",
"middle_name": "REBECCA",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-27",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3677",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.1302248",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "DP00944265",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005355002",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30610026",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coal Grove, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.