Provider Demographics
NPI:1538043799
Name:CONDENANZA, MARIA LAURA (LPC-A)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LAURA
Last Name:CONDENANZA
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4312
Mailing Address - Country:US
Mailing Address - Phone:864-603-9434
Mailing Address - Fax:
Practice Address - Street 1:206 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4312
Practice Address - Country:US
Practice Address - Phone:864-603-9434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health