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Individual
KRISTIN CONDIE
Active
Individual
KRISTIN CONDIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
077541
NY
1041C0700X
Clinical Social Worker
Primary
R084723
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00618162
GROUP MEDICAID NUMBER
NY
Enumeration date
11/07/2007
Last updated
01/19/2021
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