Provider Demographics
NPI:1447333695
Name:DURANT, LAUREN ELIZABETH (PHD/LCAS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:DURANT
Suffix:
Gender:F
Credentials:PHD/LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 E NC HIGHWAY 54
Mailing Address - Street 2:SUITE 320
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7512
Mailing Address - Country:US
Mailing Address - Phone:919-753-1080
Mailing Address - Fax:919-753-1089
Practice Address - Street 1:249 E. NC HWY 54
Practice Address - Street 2:SUITE 320
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2490
Practice Address - Country:US
Practice Address - Phone:919-753-1080
Practice Address - Fax:919-753-1089
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2890103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000432Medicare ID - Type Unspecified
OTH000Medicare ID - Type Unspecified
NC2821179Medicare ID - Type Unspecified