Provider Demographics
NPI:1871778761
Name:CONLON, PATRICIA HERVEY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:HERVEY
Last Name:CONLON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7559 OAKBORO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7505
Mailing Address - Country:US
Mailing Address - Phone:561-676-1444
Mailing Address - Fax:
Practice Address - Street 1:5350 ATLANTIC AVE STE 106
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8112
Practice Address - Country:US
Practice Address - Phone:561-638-9209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist