Provider Demographics
NPI:1417004706
Name:DURRANT, CYNTHIA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DURRANT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:D
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA THERAPIST
Mailing Address - Street 1:693 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2489
Mailing Address - Country:US
Mailing Address - Phone:860-243-6584
Mailing Address - Fax:860-243-6591
Practice Address - Street 1:693 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2489
Practice Address - Country:US
Practice Address - Phone:860-243-6584
Practice Address - Fax:860-243-6591
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional