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General NPI Number Information
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NPI Number | 1174248801
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Entity Type | Organization
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Legal Business Name | CSDURGIN COUNSELING, LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 18 ON THE COMMON SUITE 15
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City | LYME
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State | NH
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Zip | 03768
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Country | US
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Telephone | 802-230-7836
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 204
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City | LYME
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State | NH
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Zip | 03768-0204
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Country | US
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Telephone | 802-230-7836
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | CHRISTY S DURGIN
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Credential | LCMHC
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Telephone | 802-230-7836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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