Provider Demographics
NPI:1043725575
Name:DURANT, DONALD RAY JR (PLADC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RAY
Last Name:DURANT
Suffix:JR
Gender:M
Credentials:PLADC
Other - Prefix:MR
Other - First Name:DONALD
Other - Middle Name:RAY
Other - Last Name:DURANT
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:PLADC
Mailing Address - Street 1:2915 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3863
Mailing Address - Country:US
Mailing Address - Phone:402-451-3553
Mailing Address - Fax:
Practice Address - Street 1:2915 GRANT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3863
Practice Address - Country:US
Practice Address - Phone:402-451-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1325101YA0400X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty