Provider Demographics
NPI:1679821326
Name:DURIK, EMILY A (LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:DURIK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:A
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 748519
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8519
Mailing Address - Country:US
Mailing Address - Phone:904-376-3800
Mailing Address - Fax:904-376-3998
Practice Address - Street 1:820 PRUDENTIAL DR
Practice Address - Street 2:SUITE 510
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8210
Practice Address - Country:US
Practice Address - Phone:904-376-3800
Practice Address - Fax:904-202-2966
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional