Leslie Gayle Condon, LPC
Individual provider Active NPI Counselor · South Lyon, MI
NPI 1346808656 · NPPES record last updated Jun 1, 2019
Key facts
- NPI
- 1346808656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 6401004681 (MI)
- Practice address
- 127 N Lafayette St
South Lyon, MI 48178-1210 - Phone
- (248) 231-0601
- NPI assigned
- Jun 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401004681 | MI | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401004681 | MI | Yes |
Addresses
Primary practice location
127 N Lafayette St
South Lyon, MI 48178-1210
Mailing address
28246 Oakmonte Cir E
New Hudson, MI 48165-8039
Phone (248) 231-0601
Other providers in South Lyon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.