Provider Demographics
NPI:1033348214
Name:DURU, KINGSLEY I (MSW,MFT)
Entity Type:Individual
Prefix:
First Name:KINGSLEY
Middle Name:I
Last Name:DURU
Suffix:
Gender:M
Credentials:MSW,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 FONTAINBLEAU DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3808
Mailing Address - Country:US
Mailing Address - Phone:202-210-3589
Mailing Address - Fax:
Practice Address - Street 1:7606 FONTAINBLEAU DR
Practice Address - Street 2:211
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3808
Practice Address - Country:US
Practice Address - Phone:202-210-3589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLMFT000080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional