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NPI Code Detail

MEDICARE: DEDRA DARA DURAN LCSW

MEDICARE: DEDRA DARA DURAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social WorkerCSW.09932066CO

General Provider Information

NPI Number : 1437353174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEDRA DARA DURAN LCSW
Provider Business Mailing Address
First Line : 1795 JET WING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-2332
Country : US
Telephone Number : 719-572-6100
Fax Number :
Provider Business Practice Location Address
First Line : 1795 JET WING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-2332
Country : US
Telephone Number : 719-572-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 08/01/2025

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