Provider Demographics
NPI:1598229239
Name:WINN, KURT DUANE (LPC)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:DUANE
Last Name:WINN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N DALLAS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2445
Mailing Address - Country:US
Mailing Address - Phone:214-731-3131
Mailing Address - Fax:214-788-1352
Practice Address - Street 1:255 N DALLAS AVE STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2445
Practice Address - Country:US
Practice Address - Phone:214-731-3131
Practice Address - Fax:214-788-1352
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX396807501Medicaid