Provider Demographics
NPI:1609550946
Name:DURYEA, CHRISTINA (LMHCA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DURYEA
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 11TH AVE APT 921
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1263
Mailing Address - Country:US
Mailing Address - Phone:917-887-0123
Mailing Address - Fax:
Practice Address - Street 1:594 BUSHWICK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-7908
Practice Address - Country:US
Practice Address - Phone:646-926-4715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP121915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health