Provider Demographics
NPI:1275289142
Name:DURRAH, LOIS REGINA (LPC)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:REGINA
Last Name:DURRAH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5106 BORMAN DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-3400
Mailing Address - Country:US
Mailing Address - Phone:864-398-9073
Mailing Address - Fax:
Practice Address - Street 1:5106 BORMAN DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3400
Practice Address - Country:US
Practice Address - Phone:864-398-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8139101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health