MEDICARE: DANIELLE DURON

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	101YM0800X	Mental Health Counselor
2	101Y00000X	Counselor	6401013317	MI

General Provider Information

NPI Number	:	1811282916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE DURON

Provider Business Mailing Address
First Line	:	2566 WOODMEADOW DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-8031
Country	:	US
Telephone Number	:	616-719-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	12330 JAMES ST STE A80
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424-8581
Country	:	US
Telephone Number	:	616-757-5667
Fax Number	:

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

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/20/2023

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Directions to “ DANIELLE DURON ” Practice Location

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