Provider Demographics
NPI:1326141607
Name:DURANT, RAYMOND (LICSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:DURANT
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2468 WOODBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3632
Mailing Address - Country:US
Mailing Address - Phone:210-566-7775
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER BLVD
Practice Address - Street 2:SOCIAL WORK SERVICE #122
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3031871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical