Provider Demographics
NPI:1831920750
Name:DURAN, MICKI (LPC)
Entity type:Individual
Prefix:
First Name:MICKI
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 E MONROE AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1980
Mailing Address - Country:US
Mailing Address - Phone:619-665-2568
Mailing Address - Fax:
Practice Address - Street 1:8 E MONROE AVE APT 206
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22301-1980
Practice Address - Country:US
Practice Address - Phone:619-665-2568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health