Healthcare Provider Details

I. General information

NPI: 1891540050
Provider Name (Legal Business Name): TRISHA ANNE DURAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26731 W POINT MACKENZIE RD # B-301
WASILLA AK
99623-8709
US

IV. Provider business mailing address

2521 E MOUNTAIN VILLAGE DR # B-301
WASILLA AK
99654-7373
US

V. Phone/Fax

Practice location:
  • Phone: 907-376-4534
  • Fax:
Mailing address:
  • Phone: 906-458-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number255641
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: