Provider Demographics
NPI:1659547032
Name:CONDON, LINDA M (LMHC, TEP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:CONDON
Suffix:
Gender:F
Credentials:LMHC, TEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3321
Mailing Address - Country:US
Mailing Address - Phone:727-543-9128
Mailing Address - Fax:
Practice Address - Street 1:2641 HARBOR CIR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1713
Practice Address - Country:US
Practice Address - Phone:727-543-9128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9926139OtherAETNA
FLZ155SOtherBLUE CROSS BLUE SHIELD