Provider Demographics
NPI:1336965995
Name:DURAN, TIMOTHY LUCAS (LPC-A)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LUCAS
Last Name:DURAN
Suffix:
Gender:X
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 LOOKOUT DR
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-2136
Practice Address - Country:US
Practice Address - Phone:830-313-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95960101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor