Provider Demographics
NPI:1710195169
Name:DURKEE, DONNA MARIE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:DURKEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 WALKER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CLARENDON
Mailing Address - State:VT
Mailing Address - Zip Code:05759-9305
Mailing Address - Country:US
Mailing Address - Phone:802-775-5046
Mailing Address - Fax:802-775-5046
Practice Address - Street 1:977 WALKER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH CLARENDON
Practice Address - State:VT
Practice Address - Zip Code:05759-9305
Practice Address - Country:US
Practice Address - Phone:802-775-5046
Practice Address - Fax:802-775-5046
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900006041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1815Medicaid
VTVN1815Medicare ID - Type UnspecifiedPSYCHOTHERAPIST