Provider Demographics
NPI:1639786635
Name:DURAND STERN, LARA (LPC)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:DURAND STERN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 MESA BLANCA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-2613
Mailing Address - Country:US
Mailing Address - Phone:210-701-5755
Mailing Address - Fax:
Practice Address - Street 1:1153 MESA BLANCA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2613
Practice Address - Country:US
Practice Address - Phone:210-701-5755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health