Provider Demographics
NPI:1881975217
Name:CONDON KELLY, MAUREEN J (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:J
Last Name:CONDON KELLY
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14255 US HIGHWAY 1 STE 231
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1490
Mailing Address - Country:US
Mailing Address - Phone:561-318-9740
Mailing Address - Fax:
Practice Address - Street 1:14255 US HIGHWAY 1 STE 231
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1490
Practice Address - Country:US
Practice Address - Phone:561-318-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSW8111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical