Individual
JESSICA SAMFORD CONLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC - MHSP
Contact information
Practice address
713 W MAIN ST, SUITE 100, HENDERSONVILLE, TN 37075-2150
(615) 415-2212
(866) 867-4298
Mailing address
189 CHEROKEE RD, HENDERSONVILLE, TN 37075-3759
(615) 415-2212
(866) 867-4298
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2173
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12069176
CAQH
TN
01
—
2173
LPC- MHSP LIC #
TN
Enumeration date
06/10/2008
Last updated
08/03/2012
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