Provider Demographics
NPI:1689273062
Name:CONDIT, STEPHANIE (MA, LPC, ATR)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CONDIT
Suffix:
Gender:F
Credentials:MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N STARRETT RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-5743
Mailing Address - Country:US
Mailing Address - Phone:504-457-9218
Mailing Address - Fax:
Practice Address - Street 1:1000 VETERANS MEMORIAL BLVD STE 310
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2852
Practice Address - Country:US
Practice Address - Phone:504-220-1483
Practice Address - Fax:888-248-7189
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA8450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator