Provider Demographics
NPI:1720143001
Name:DURBIN, MARIA (LISW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DURBIN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 N RIDGE RD E
Mailing Address - Street 2:SUITE E
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3400
Mailing Address - Country:US
Mailing Address - Phone:440-260-6108
Mailing Address - Fax:440-282-3400
Practice Address - Street 1:2173 N RIDGE RD E
Practice Address - Street 2:SUITE E
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3400
Practice Address - Country:US
Practice Address - Phone:440-260-6108
Practice Address - Fax:440-282-3400
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-06000231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical