Provider Demographics
NPI:1750158499
Name:DURHAM, BEATRICE ELLEN (LMSW)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:ELLEN
Last Name:DURHAM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:ALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08001-0092
Mailing Address - Country:US
Mailing Address - Phone:609-805-9935
Mailing Address - Fax:
Practice Address - Street 1:100 COMMERCE DR STE 300
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2878
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0011324104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker