Provider Demographics
NPI:1740675537
Name:DURANT, MICHAEL S (LCPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:DURANT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W PATRICK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6933
Mailing Address - Country:US
Mailing Address - Phone:301-662-3223
Mailing Address - Fax:301-662-7921
Practice Address - Street 1:219 W PATRICK ST
Practice Address - Street 2:SUITE A
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6933
Practice Address - Country:US
Practice Address - Phone:301-662-3223
Practice Address - Fax:301-662-7921
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6035101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health