Provider Demographics
NPI:1942458336
Name:DURAN, SUSAN LYNN (LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
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 1:3201 CHERRY RIDGE ST
Mailing Address - Street 2:C-320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4823
Mailing Address - Country:US
Mailing Address - Phone:210-541-1447
Mailing Address - Fax:210-541-9995
Practice Address - Street 1:3201 CHERRY RIDGE ST
Practice Address - Street 2:C-320
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4823
Practice Address - Country:US
Practice Address - Phone:210-541-1447
Practice Address - Fax:210-541-9995
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional