Provider Demographics
NPI:1710180369
Name:DURANT, CARRIE JO (LIMHP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:JO
Last Name:DURANT
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:JO
Other - Last Name:HILLEBRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LIMHP
Mailing Address - Street 1:9402 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-2651
Mailing Address - Country:US
Mailing Address - Phone:402-871-9979
Mailing Address - Fax:
Practice Address - Street 1:1941 S 42ND ST STE 129
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2938
Practice Address - Country:US
Practice Address - Phone:402-871-9979
Practice Address - Fax:402-614-9947
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8125101YM0800X
NE696101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health