Provider Demographics
NPI:1548396963
Name:DURDEN, BETTY JEAN (MSW LMSW)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:JEAN
Last Name:DURDEN
Suffix:
Gender:F
Credentials:MSW LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:MI
Mailing Address - Zip Code:49304-7984
Mailing Address - Country:US
Mailing Address - Phone:231-745-4624
Mailing Address - Fax:231-745-5031
Practice Address - Street 1:1615 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:MI
Practice Address - Zip Code:49304-7984
Practice Address - Country:US
Practice Address - Phone:231-745-4624
Practice Address - Fax:231-745-5031
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OD16322Medicare ID - Type Unspecified