Provider Demographics
NPI:1518841568
Name:CONDON, SHAUNA
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:CONDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COMMON ST
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-9519
Mailing Address - Country:US
Mailing Address - Phone:508-560-2252
Mailing Address - Fax:
Practice Address - Street 1:200 N MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2354
Practice Address - Country:US
Practice Address - Phone:413-529-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health