Provider Demographics
NPI:1629234026
Name:DURBAS, DAVID M (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:DURBAS
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 1:29 HARWICH LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1437
Mailing Address - Country:US
Mailing Address - Phone:860-232-8843
Mailing Address - Fax:860-296-5939
Practice Address - Street 1:29 HARWICH LN
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1437
Practice Address - Country:US
Practice Address - Phone:860-232-8843
Practice Address - Fax:860-296-5939
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health