Provider Demographics
NPI:1982495461
Name:DURBIN, SIMONE (LSAA, CWS)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:DURBIN
Suffix:
Gender:F
Credentials:LSAA, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 WASHINGTON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2930
Mailing Address - Country:US
Mailing Address - Phone:505-492-8440
Mailing Address - Fax:
Practice Address - Street 1:125 TRUMAN ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1330
Practice Address - Country:US
Practice Address - Phone:505-895-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0294101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)