Provider Demographics
NPI:1962760603
Name:CONDIT, CASSITY KRISCHELLE (LPC)
Entity type:Individual
Prefix:MS
First Name:CASSITY
Middle Name:KRISCHELLE
Last Name:CONDIT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 971464
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-1464
Mailing Address - Country:US
Mailing Address - Phone:801-477-0551
Mailing Address - Fax:
Practice Address - Street 1:2696 N UNIVERSITY AVE STE 104B
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3827
Practice Address - Country:US
Practice Address - Phone:801-477-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6362482-6004101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health