Provider Demographics
NPI:1356363113
Name:DURHAM, JOAN SAUNDERS (LPC NCC)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:SAUNDERS
Last Name:DURHAM
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:FULLER
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC NCC
Mailing Address - Street 1:110 HARPER FARM LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-9585
Mailing Address - Country:US
Mailing Address - Phone:252-442-8891
Mailing Address - Fax:252-972-1004
Practice Address - Street 1:142A WOODRIDGE CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2294
Practice Address - Country:US
Practice Address - Phone:252-972-1000
Practice Address - Fax:252-972-1004
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC4785101Y00000X
NCNOC46520101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13890OtherBCBS
NC6102206Medicaid