Mary Ellen Condas, LCSW

Individual provider Active NPI Clinical Social Worker · Galt, CA

NPI 1396978201 · NPPES record last updated Aug 25, 2009

Key facts

NPI
1396978201
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS 18162 (CA)
Practice address
216 N Lincoln Way Ste 30
Galt, CA 95632-1715
Phone
(916) 708-0489
NPI assigned
Aug 25, 2009
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

LicenseStateTypeSpecialty
LCS 18162CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 18162 CA Yes

Addresses

Primary practice location

216 N Lincoln Way Ste 30
Galt, CA 95632-1715

Mailing address

216 N Lincoln Way Ste 30
Galt, CA 95632-1715
Phone (916) 708-0489

Other providers in Galt, CA

All providers in Galt, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.