Healthcare Provider Details

I. General information

NPI: 1689273062
Provider Name (Legal Business Name): STEPHANIE CONDIT M.A., LPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 07/15/2023
Certification Date: 07/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 VETERANS MEMORIAL BLVD STE 310
METAIRIE LA
70005-2852
US

IV. Provider business mailing address

1401 N STARRETT RD
METAIRIE LA
70003-5743
US

V. Phone/Fax

Practice location:
  • Phone: 504-220-1483
  • Fax: 888-248-7189
Mailing address:
  • Phone: 504-457-9218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8450
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: