Provider Demographics
NPI:1225126030
Name:CONDOL, PAULA J (LPCC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:CONDOL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:J
Other - Last Name:JOHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:8041 WHITE OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-9330
Mailing Address - Country:US
Mailing Address - Phone:701-202-7073
Mailing Address - Fax:
Practice Address - Street 1:8041 WHITE OAK LOOP
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-9330
Practice Address - Country:US
Practice Address - Phone:701-202-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND402-4-15-98-123101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND20555Medicare PIN