| Doctor Name: | MRS. LORI ANN CONDON |
| NPI Number: | 1649592940 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CADC |
| License Number: | 154 |
| Business Practice Address: | 301 Andrews Avenue Clinical Social Worker Ft. Rucker, AL - 36330 |
| Business Phone Number: | 3342557040 |
| Business Fax Number: | 3342557716 |
| Mailing Address: | 215 Britt Dr, ENTERPRISE |
| State: | AL |
| Postal Code: | 363307881 |
| Phone Number: | 3344894289 |
| Fax Number: | 3344894263 |
| NPI Enumeration Date: | 02/28/2010 |
| NPI Last Update Date: | 12/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 154 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ZZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |