Provider Demographics
NPI:1942291182
Name:DUREN, LATAYA ELAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LATAYA
Middle Name:ELAINE
Last Name:DUREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LATAYA
Other - Middle Name:ELAINE
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, BCD
Mailing Address - Street 1:17306 BROOKHOLLOW GROVE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6046
Mailing Address - Country:US
Mailing Address - Phone:713-775-1155
Mailing Address - Fax:
Practice Address - Street 1:9501 FARRELL RD
Practice Address - Street 2:DEPT OF BEHAVORIAL HEALTH, DEWITT ARMY HOSPITAL
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-805-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical