Provider Demographics
NPI:1831540509
Name:DUFF, NATHAN (MED, LPC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:DUFF
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 WARDS RD
Mailing Address - Street 2:UNIT G1 #232
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2977
Mailing Address - Country:US
Mailing Address - Phone:434-426-2126
Mailing Address - Fax:
Practice Address - Street 1:4026 WARDS RD
Practice Address - Street 2:UNIT G1 #232
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2977
Practice Address - Country:US
Practice Address - Phone:434-426-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health