Individual
MR. RICHARD ALLEN CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
8255 S 42ND ST, OMAHA, NE 68147-1700
(402) 898-4135
Mailing address
3300 N 60TH ST, OMAHA, NE 68104-3402
(402) 554-0520
(402) 551-8797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
829
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092619
—
NE
Enumeration date
08/19/2011
Last updated
08/19/2011
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