Healthcare Provider Details

I. General information

NPI: 1205755535
Provider Name (Legal Business Name): KATHLEEN MARIE KONDAS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 QUADRANGLE DR STE 320
CHAPEL HILL NC
27517-7803
US

IV. Provider business mailing address

3605 MANFORD DR
DURHAM NC
27707-5164
US

V. Phone/Fax

Practice location:
  • Phone: 984-355-9741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP024049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: