Provider Demographics
NPI:1457827081
Name:CONDREY, ELIZABETH (LMSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CONDREY
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 1:234 S ALLEN ST APT 5
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2030
Mailing Address - Country:US
Mailing Address - Phone:518-763-5281
Mailing Address - Fax:
Practice Address - Street 1:10 COLVIN AVE STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1242
Practice Address - Country:US
Practice Address - Phone:518-763-5281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098658104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker