Healthcare Provider Details

I. General information

NPI: 1013626852
Provider Name (Legal Business Name): LAURA MARCELA ALONSO-PRICE MSN, LISW-CP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT FRANCIS DR
GREENVILLE SC
29601-3999
US

IV. Provider business mailing address

1 SAINT FRANCIS DR
GREENVILLE SC
29601-3955
US

V. Phone/Fax

Practice location:
  • Phone: 864-380-0555
  • Fax: 864-566-6552
Mailing address:
  • Phone: 864-255-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14961
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number220234
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number27054
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: