Provider Demographics
NPI:1861920043
Name:CONDELL, ANDREA N (LMSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:N
Last Name:CONDELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13305 227TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1740
Mailing Address - Country:US
Mailing Address - Phone:718-926-8129
Mailing Address - Fax:
Practice Address - Street 1:13305 227TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1740
Practice Address - Country:US
Practice Address - Phone:718-926-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095368104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker