Provider Demographics
NPI:1588837934
Name:DURAND, BEVERLY
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:DURAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29974
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70189-0974
Mailing Address - Country:US
Mailing Address - Phone:504-458-8614
Mailing Address - Fax:504-240-2858
Practice Address - Street 1:7530 MALVERN DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2114
Practice Address - Country:US
Practice Address - Phone:504-458-8614
Practice Address - Fax:504-240-2858
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
LA35262887K172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health