Provider Demographics
NPI:1720696271
Name:DURAN, RODRIGO (MS, LPC)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:
Last Name:DURAN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 E EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-9416
Mailing Address - Country:US
Mailing Address - Phone:956-903-5669
Mailing Address - Fax:
Practice Address - Street 1:9001 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-9416
Practice Address - Country:US
Practice Address - Phone:956-903-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional