Individual provider Active NPI

Glyndora Spring Condon, MS, LPC, CTMH, CCTP,

  • Professional Counselor
  • Cleveland, TN
National Provider Identifier
1184178428
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC3583 Issued in TN
Practice address
1510 Stuart Rd NE Ste 101
Cleveland, TN 37312-5869
Phone
(423) 790-4906
Fax
(423) 790-7074
NPI assigned
Aug 3, 2016
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC3583 TN Primary

Addresses

Primary practice location

1510 Stuart Rd NE Ste 101
Cleveland, TN 37312-5869

Mailing address

241 Lakewood Circle Dr
Decatur, TN 37322-8243
Phone (423) 790-4906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130001290 TN Practitioner - Mental Health Counselor 7416287230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1510 Stuart Rd NE
Suite 101
Cleveland, TN 37312-5869
Phone (423) 790-4906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC3583TNMDProfessional Counselor
3583TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Heal and Hope Counseling Services LLC Professional CurrentSince Dec 30, 2013 Accepting new patients

Locations

1510 Stuart Rd NE
Ste 101
Cleveland, TN 37312
Phone (423) 790-4906

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1184178428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 LAKEWOOD CIRCLE DR",
            "city": "DECATUR",
            "state": "TN",
            "postal_code": "373228243",
            "telephone_number": "423-790-4906",
            "fax_number": "423-790-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 STUART RD NE STE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125869",
            "telephone_number": "423-790-4906",
            "fax_number": "423-790-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDON",
        "first_name": "GLYNDORA",
        "middle_name": "SPRING",
        "credential": "MS, LPC, CTMH, CCTP,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC3583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.