Provider Demographics
NPI:1528027182
Name:DURNIL, VICTOR WAYNE (LCPC)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:WAYNE
Last Name:DURNIL
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-4932
Mailing Address - Country:US
Mailing Address - Phone:208-921-6544
Mailing Address - Fax:208-395-8049
Practice Address - Street 1:1250 W CHERRY LN
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1514
Practice Address - Country:US
Practice Address - Phone:208-887-1911
Practice Address - Fax:208-895-8049
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC3397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional