Provider Demographics
NPI:1689109589
Name:DUHART, KUBLAI K (LCPC)
Entity Type:Individual
Prefix:MR
First Name:KUBLAI
Middle Name:K
Last Name:DUHART
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1167
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1114
Mailing Address - Country:US
Mailing Address - Phone:443-738-4724
Mailing Address - Fax:
Practice Address - Street 1:10989 RED RUN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3285
Practice Address - Country:US
Practice Address - Phone:443-738-4724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional