Provider Demographics
NPI:1518552777
Name:CONDON, LEIGH G (MSW)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:G
Last Name:CONDON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 E CLINTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-4193
Mailing Address - Country:US
Mailing Address - Phone:815-723-0331
Mailing Address - Fax:815-723-0321
Practice Address - Street 1:58 E CLINTON ST STE 200
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4193
Practice Address - Country:US
Practice Address - Phone:815-723-0331
Practice Address - Fax:815-723-0321
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor