MEDICARE: DDP THERAPY & CONSULTING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251300000X	Local Education Agency (LEA)
2	251B00000X	Case Management Agency
3	251S00000X	Community/Behavioral Health Agency
4	252Y00000X	Early Intervention Provider Agency
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1720818818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DDP THERAPY & CONSULTING

Provider Business Mailing Address
First Line	:	252 LYNCHWICK LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9840
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2310 S MIAMI BLVD STE 142
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-4900
Country	:	US
Telephone Number	:	704-931-8602
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DEZYRE PLUMMER
Credential	:	LCMHC
Telephone Number	:	919-360-5791

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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