Healthcare Provider Details

I. General information

NPI: 1457827081
Provider Name (Legal Business Name): ELIZABETH CONDREY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1873 WESTERN AVE STE 203
ALBANY NY
12203-5028
US

IV. Provider business mailing address

56 BELVIDERE AVE
ALBANY NY
12203-2416
US

V. Phone/Fax

Practice location:
  • Phone: 518-763-5281
  • Fax:
Mailing address:
  • Phone: 518-763-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097777
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: