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General NPI Number Information
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NPI Number | 1740405083
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Entity Type | Organization
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Legal Business Name | ANN CONDON PSYCHOTHERAPY INC.
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3937 MAIN ST
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City | BREWSTER
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State | MA
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Zip | 02631-1592
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Country | US
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Telephone | 508-240-0092
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Fax | 508-255-1311
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Provider Business Mailing Address
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Address Line | 3937 MAIN ST
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City | BREWSTER
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State | MA
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Zip | 02631-1592
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Country | US
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Telephone | 508-240-0092
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Fax | 508-255-1311
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. ANN PATRICIA CONDON
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Credential | MA,LMHC
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Telephone | 508-240-0092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4767
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License Number State | MA
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