Provider Demographics
NPI:1831790393
Name:DURANTE, DORA BROWN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:DORA
Middle Name:BROWN
Last Name:DURANTE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:DORA
Other - Middle Name:LEE
Other - Last Name:DURANTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:11402 PROSPECT CT
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9451
Mailing Address - Country:US
Mailing Address - Phone:301-327-2695
Mailing Address - Fax:
Practice Address - Street 1:11402 PROSPECT CT
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9451
Practice Address - Country:US
Practice Address - Phone:301-262-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8951101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral