KATHLEEN M CONDON (NPI# 1053580308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053580308 |
| Entity Type | Individual |
| Full Name | KATHLEEN M CONDON |
| Credential | PSY.D |
| Practice Address |
845 W Center St Suite 200 Pocatello ID 83204-4205 |
| Mailing Address |
1080 Emeline Avenue Santa Cruz CA 95060-1976 |
| Practice Telephone | 2082326260 |
| Practice Fax Number | 2082326259 |
| Mailing Telephone | 8314544872 |
| Mailing Fax Number | 8314544296 |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2017-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY-202418 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PSYCHOLOGIST LICENSE NUMBER | 24048 | 01 |
| CA | FHC70042F | 05 | |
| CA | FHC70044F | 05 | |
| CA | NPI ORGANIZATION LEGAL ENTITY | 1659315430 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720617517 | Kathleen Condon | Student in an Organized Health Care Education/Training Program | 4740 S I 10 Service Rd W Ste 200, Metairie, LA 70001-1244 | 2020-04-03 |
| 1902318728 | Kathleen Condon | Speech-Language Pathologist | 4012 Park Rd, Charlotte, NC 28209-2377 | 2017-11-02 |
| 1932371515 | Kathleen Helen Condon | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2008-03-24 |
| 1790865509 | Kathleen Anne Condon | Physician Assistant | 5920 Mcintyre St, Golden, CO 80403-7445 | 2006-10-16 |
| Street Address |
845 W CENTER ST SUITE 200 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83204-4205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912906553 | Alison Stocks | Family Medicine | 845 W Center St, Suite 200, Pocatello, ID 83204-4205 | 2005-07-15 |
| 1578850400 | Christa Santos-smith | Counselor | 845 W Center St, Suite C, Pocatello, ID 83204-4205 | 2011-06-29 |
| 1184917346 | Shannon Lavon Brown | Social Worker | 845 W Center St, Suite 200, Pocatello, ID 83204-4205 | 2011-05-20 |
| 1285868125 | Stacy Jo Pray | Counselor | 845 W Center St, Suite C, Pocatello, ID 83204-4205 | 2009-05-06 |
| 1457502700 | Nancy Goodman | Counselor | 845 W Center St, Suite 306, Pocatello, ID 83204-4205 | 2008-10-06 |
| 1194993550 | James Vonbusch | Counselor | 845 W Center St, Suite C, Pocatello, ID 83204-4205 | 2008-02-19 |
| 1336321181 | Jami Sue Price | Physician Assistant | 845 W Center St, Suite 200, Pocatello, ID 83204-4205 | 2007-12-04 |
| 1871654798 | Christy Kelshaw | Counselor | 845 W Center St, Suite C, Pocatello, ID 83204-4205 | 2006-12-13 |
| 1831132232 | Ty A Salness | Internal Medicine | 845 W Center St, Suite 200, Pocatello, ID 83204-4205 | 2006-06-14 |
| 1215929690 | David E Martin | Physician Assistant | 845 W Center St, Suite 200, Pocatello, ID 83204-4205 | 2005-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568974541 | Daniel Graham Rasmussen | Social Worker | 335 N. Main, Pocatello, ID 83204 | 2017-10-30 |
| 1801311246 | Thomas Henrie | Specialist/Technologist | 3960 Stockman Rd., Pocatello, ID 83204 | 2017-08-07 |
| 1750803110 | David Tim Williams | Counselor | 224 S. Arthur Suite 2, Pocatello, ID 83204 | 2017-07-07 |
| 1023441185 | Insight Occupational Therapy, LLC | Occupational Therapist | 158 N Main St., Pocatello, ID 83204 | 2013-08-13 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1790032431 | Wynnona Sarah Warren | Pharmacist | 911 North Main Street, Pocatello, ID 83204 | 2012-08-13 |
| 1902110380 | Belmont Management, Inc. | Intermediate Care Facility, Mentally Retarded | 6150 S. 5th Ave, Pocatello, ID 83204 | 2010-07-28 |
| 1104066539 | Rachel Ann Seibold | Speech-Language Pathologist | 1254 Swisher Rd, Pocatello, ID 83204 | 2009-02-25 |
| 1710163803 | Allen Bennett Martin | Clinic/Center | 540 South Garfield, Pocatello, ID 83204 | 2008-01-18 |
| 1174711758 | Rsm Pa Pllc | Physician Assistant | 1595 Bannock Hwy, Pocatello, ID 83204 | 2007-10-09 |
| Find all providers in zip 83204 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114192986 | Bmh, Inc. | Psychologist | 1151 Hospital Way # D-100, Pocatello, ID 83201-5091 | 2008-04-23 |
| 1255459608 | Kenneth P. Lindsey, Phd, Pa | Psychologist | 1151d Hospital Way, Suite 204, Pocatello, ID 83201-2763 | 2007-03-26 |
| 1639218241 | Cheri L. Atkins | Psychologist | 1151 Hospital Way # D, Suite 204, Pocatello, ID 83201-2763 | 2007-02-06 |
| 1063424448 | Debra Larsen Aubrey | Psychologist | 850 E Center St Ste A, Pocatello, ID 83201-5737 | 2006-08-13 |
| 1659874881 | Julie Spencer | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2018-03-14 |
| 1962923219 | Justin Paul Schrotenboer | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2017-06-27 |
| 1144754235 | Yaeeun Lee | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2017-04-14 |
| 1093163073 | Anne Stegenga | Psychologist | 465 Memorial Dr, Pocatello, ID 83201-4008 | 2016-05-31 |
| 1255715330 | Colin Mahoney | Psychologist | 1246 Yellowstone Ave, Ste C5, Pocatello, ID 83201-4374 | 2015-07-17 |
| 1679971584 | Erika Coles | Psychologist | 500 S 11th Ave Ste 400, Pocatello, ID 83201 | 2014-12-09 |
| Find all providers in POCATELLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.