Provider Demographics
NPI:1396016788
Name:CLONDAS, LUCITA C (LICSW)
Entity Type:Individual
Prefix:
First Name:LUCITA
Middle Name:C
Last Name:CLONDAS
Suffix:
Gender:F
Credentials:LICSW
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 834
Mailing Address - Street 2:
Mailing Address - City:ASSONET
Mailing Address - State:MA
Mailing Address - Zip Code:02702-0897
Mailing Address - Country:US
Mailing Address - Phone:508-801-7959
Mailing Address - Fax:
Practice Address - Street 1:12 HARDING ST STE 206
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1232
Practice Address - Country:US
Practice Address - Phone:774-855-6974
Practice Address - Fax:774-855-9994
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1162941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical