| Doctor Name: | DR. MARK CONROY |
| NPI Number: | 1427165653 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ED.D., LCSW |
| License Number: | LCS12224 |
| Business Practice Address: | 100 Prison Rd Represa, CA - 956713000 |
| Business Phone Number: | 9169858610 |
| Business Fax Number: | |
| Mailing Address: | 267 Canyon Falls Dr, FOLSOM |
| State: | CA |
| Postal Code: | 956307172 |
| Phone Number: | 9163374415 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 06/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS12224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |