Provider Demographics
NPI:1003334285
Name:DURDEN, JOHN (MSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DURDEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 KAATSKILL WAY
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-3002
Mailing Address - Country:US
Mailing Address - Phone:518-369-9308
Mailing Address - Fax:
Practice Address - Street 1:2452 ROUTE 9, SUITE 206
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-292-5433
Practice Address - Fax:518-899-4930
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY098976101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health