Provider Demographics
NPI:1295306587
Name:DURSO, CATHY ANN (LPC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:DURSO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GOLD MINE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROXBURY TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9122
Mailing Address - Country:US
Mailing Address - Phone:973-252-4499
Mailing Address - Fax:
Practice Address - Street 1:4 GOLD MINE RD STE 3
Practice Address - Street 2:
Practice Address - City:ROXBURY TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07836-9122
Practice Address - Country:US
Practice Address - Phone:973-252-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00738100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist