Provider Demographics
NPI:1982871844
Name:DURRETT, CRYSTAL DAWN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:DURRETT
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 1:427 F ST STE 234
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1037
Mailing Address - Country:US
Mailing Address - Phone:707-954-7060
Mailing Address - Fax:
Practice Address - Street 1:427 F ST STE 234
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1037
Practice Address - Country:US
Practice Address - Phone:707-954-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 190421041C0700X
CALCSW 255701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical