Individual
SHIRLEY O. CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
(757) 819-6292
Mailing address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
(757) 819-6292
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701003283
VA
101Y00000X
Counselor
0701003283LPC
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089111
OPTIMA/SENTARA
VA
01
—
143676
ANTHEM TRIGON
VA
01
—
343506
FED HEALTH NET TRICARE
VA
01
—
484893000
MAGELLAN HEALTH
VA
01
—
518306
VALUE OPTIONS
VA
Enumeration date
11/04/2006
Last updated
09/05/2013
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