Healthcare Provider Details

I. General information

NPI: 1295405108
Provider Name (Legal Business Name): EMERY DURNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MAPLE ST STE 400
MARLBOROUGH MA
01752-3200
US

IV. Provider business mailing address

340 MAPLE ST STE 400
MARLBOROUGH MA
01752-3200
US

V. Phone/Fax

Practice location:
  • Phone: 508-573-5454
  • Fax:
Mailing address:
  • Phone: 508-573-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10006014
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: