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NPI Code Detail

MEDICARE: MR. JARAD EUGENE DURR LMHC

MEDICARE: MR. JARAD EUGENE DURR LMHC
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
1101YM0800XMental Health Counselor
2101YM0800XMental Health CounselorCMH0208451NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CMH-0208451OTHERNMNEW MEXICO STATE LICENSE

General Provider Information

NPI Number : 1821636127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JARAD EUGENE DURR LMHC
Provider Business Mailing Address
First Line : 1600 SAN PEDRO DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-6734
Country : US
Telephone Number : 505-404-0717
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SAN PEDRO DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-6734
Country : US
Telephone Number : 505-404-0717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2019
Last Update Date : 12/17/2019

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