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General NPI Number Information
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NPI Number | 1396034013
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Entity Type | Individual
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Provider Name | YILDIZ DURAL LCSW, LCADC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 18 WALLACE ST
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City | RED BANK
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State | NJ
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Zip | 07701-1857
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Country | US
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Telephone | 732-518-8820
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-0367
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Country | US
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Telephone | 732-518-8820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00172800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05428700
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License Number State | NJ
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