Provider Demographics
NPI:1982791257
Name:DURKIN, BERNADETTE T (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:T
Last Name:DURKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 DRY MILL RD. SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3408
Mailing Address - Country:US
Mailing Address - Phone:703-777-2144
Mailing Address - Fax:703-777-3872
Practice Address - Street 1:418 DRY MILL RD SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3408
Practice Address - Country:US
Practice Address - Phone:703-777-2144
Practice Address - Fax:703-777-3872
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical