Provider Demographics
NPI:1609662097
Name:DURANTE, DAVID MICHAEL (BCBA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:DURANTE
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 BOROWOOD CT
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-5658
Mailing Address - Country:US
Mailing Address - Phone:423-502-8522
Mailing Address - Fax:844-284-7273
Practice Address - Street 1:124 AUSTIN ST STE 1
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3953
Practice Address - Country:US
Practice Address - Phone:423-502-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1825103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst