Provider Demographics
NPI:1679181481
Name:DURRETT, KATHRYN LYNNE (PLPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LYNNE
Last Name:DURRETT
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 AYSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5035
Mailing Address - Country:US
Mailing Address - Phone:986-768-6136
Mailing Address - Fax:
Practice Address - Street 1:1125 N TONTI ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3598
Practice Address - Country:US
Practice Address - Phone:504-821-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8221101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor