Provider Demographics
NPI:1699516252
Name:CONDRON, BRIDGET (LMSW)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:CONDRON
Suffix:
Gender:X
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 16TH ST UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5501
Mailing Address - Country:US
Mailing Address - Phone:703-336-2624
Mailing Address - Fax:
Practice Address - Street 1:250 16TH ST UNIT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5501
Practice Address - Country:US
Practice Address - Phone:703-336-2624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12201501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health