Cullen Conerly, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-005722 Issued in AZ

Practice address

1130 E Missouri Ave Ste 800
Phoenix, AZ 85014-2726

Phone

(423) 505-8885

NPI assigned

Jan 23, 2024

Last updated

Jan 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1861254112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E MISSOURI AVE STE 800",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142726",
            "telephone_number": "423-505-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E MISSOURI AVE STE 800",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142726",
            "telephone_number": "423-505-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONERLY",
        "first_name": "CULLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY-005722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Conditt, FNP-C
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• Julia Ann Coney, LMSW
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• Anthony Michael Conforti, MD

• Clinical Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.