Provider Demographics
NPI:1891847000
Name:CONIDI, ANNE M (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:CONIDI
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MCCARTHY
Other - Last Name:CONIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1315 BUTTERFIELD
Mailing Address - Street 2:SUTE 220
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515
Mailing Address - Country:US
Mailing Address - Phone:708-466-9061
Mailing Address - Fax:
Practice Address - Street 1:1315 BUTTERFIELD
Practice Address - Street 2:SUTE 220
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515
Practice Address - Country:US
Practice Address - Phone:708-466-9061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635043OtherBLUE CROSS #