Michella Conrad, M.ED.,PSYD CANDIDATE

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4119 Montrose Blvd
Houston, TX 77006-4963

Phone

(512) 956-6463

NPI assigned

Aug 4, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michella Fanini Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1700513215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 MONTROSE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770064963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 MONTROSE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770064963",
            "telephone_number": "512-956-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "MICHELLA",
        "credential": "M.ED.,PSYD CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1898175",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLA",
            "last_name": "FANINI",
            "credential": "M.ED., PSYD CANDIDAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Conrad F. Kelly, O.D.,LLC
• Conrad Lo Inc
• Collin Michael Conrad, M.D.
• Elizabeth Conrad, MD
• Larry Paul Conrad, MD
• Sarah Kay Conrad, M.D.
• Conroe Cares Home Care LLC
• Conroe Physicians Consultants PLLC
• David Scott Conrow, M.D.
• Jacob Ryan Conroy, MD

• Student in an Organized Health Care Education/Training Program in Houston, TX
• Providers in Houston, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.