Provider Demographics
NPI:1255159422
Name:CONDER, LAUREN (PHD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CONDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 ROBERTA FARMS CT SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9308
Mailing Address - Country:US
Mailing Address - Phone:919-302-4527
Mailing Address - Fax:
Practice Address - Street 1:3251 ROBERTA FARMS CT SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9308
Practice Address - Country:US
Practice Address - Phone:919-302-4527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical