Provider Demographics
NPI:1073631214
Name:DURRETT, YVETTE LORRAINE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:LORRAINE
Last Name:DURRETT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:Y
Other - Middle Name:LORRAINE
Other - Last Name:DURRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:6 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1833
Mailing Address - Country:US
Mailing Address - Phone:732-670-3999
Mailing Address - Fax:
Practice Address - Street 1:621 SHREWSBURY AVE STE 115
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4181
Practice Address - Country:US
Practice Address - Phone:732-670-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05262500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker