Provider Demographics
NPI:1659796043
Name:CONDIT, JULIA MICHELLE (LPC,MA,BS,NBCC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MICHELLE
Last Name:CONDIT
Suffix:
Gender:F
Credentials:LPC,MA,BS,NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-3512
Mailing Address - Country:US
Mailing Address - Phone:860-348-2292
Mailing Address - Fax:860-224-1918
Practice Address - Street 1:180 CLINTON ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3512
Practice Address - Country:US
Practice Address - Phone:860-348-2292
Practice Address - Fax:860-224-1918
Is Sole Proprietor?:No
Enumeration Date:2014-02-22
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT13824903OtherCAQH
CT290507OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS
CTC082012001939OtherCT STATE DEPARTMENT OF EDUCATION 068-SCHOOL COUNSELOR
CT13824903OtherCAQH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CTD339230-TORRINGTONOtherBEACON HEALTH STRATEGIES
CTNOT ELIGIBLEOtherMHN- MANAGED HEALTH NETWORK
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH/CONNECTICARE WELLMORE GRP/FACILITY
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherUBH/OXFORD FREEDOM-LIBERTY WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH WELLMORE/GRP/FACILITY
CT290507OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS
CTC082012001939OtherCT STATE DEPARTMENT OF EDUCATION 068-SCHOOL COUNSELOR
CTNOT ELIGIBLEMedicare PIN