MEDICARE: MRS. AMANDA ELMORE DURHAM LPC, LCAS-A

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-21716	NC
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164455358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA ELMORE DURHAM LPC, LCAS-A

Provider Business Mailing Address
First Line	:	200 DOCTORS DR STE C
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6308
Country	:	US
Telephone Number	:	910-333-5956
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 DOCTORS DR STE C
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6308
Country	:	US
Telephone Number	:	910-333-5956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	02/12/2018

Similar Medicare Providers

1689537516 — ENLIGHT PSYCHOLOGICAL & ASSESSMENT SERVICES, PLLC
Practice Location Address:

200 DOCTORS DR STE M
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-526-0326
Practice Fax: 910-954-1449

1427016435 — DR. GEORGE M. CONEKIN III O.D.
Practice Location Address:

200 DOCTORS DR , SUITE K
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-353-0541
Practice Fax: 910-353-5353

1770501678 — ADNAN TAJ-ELDIN MD
Practice Location Address:

200 DOCTORS DR , SUITE I
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-353-6327
Practice Fax: 910-353-6329

1710086236 — DR. ROBERT E KELL M.D
Practice Location Address:

200 DOCTORS DR STE F
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-353-1499
Practice Fax: 910-355-0404

1265593693 — RONALD MACK HAMMOCK MD
Practice Location Address:

200 DOCTORS DR , SUITE C
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-353-9994
Practice Fax: 910-353-5784

1710036801 — DR. THOMAS W BELL JR. D.D.S.
Practice Location Address:

200 DOCTORS DR , SUITE A
JACKSONVILLE, NC
28546-6308

Practice Phone: 910-353-5171
Practice Fax: 910-353-8810

Directions to “ MRS. AMANDA ELMORE DURHAM LPC, LCAS-A” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.