Provider Demographics
NPI:1083240493
Name:DURAN, GLADYS A (LCSW)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:A
Last Name:DURAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SW 96TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2931
Mailing Address - Country:US
Mailing Address - Phone:305-321-9998
Mailing Address - Fax:
Practice Address - Street 1:1421-1 SW 107TH AVE
Practice Address - Street 2:#230
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3317
Practice Address - Country:US
Practice Address - Phone:305-321-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical