Provider Demographics
NPI:1205835444
Name:DURANT, LAURA SHARON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SHARON
Last Name:DURANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 AUTUMN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2111
Mailing Address - Country:US
Mailing Address - Phone:407-654-7572
Mailing Address - Fax:
Practice Address - Street 1:1041 AUTUMN LEAF DR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2111
Practice Address - Country:US
Practice Address - Phone:407-654-7572
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW59901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical