Provider Demographics
NPI:1679181481
Name:DURRETT, KATHRYN LYNNE (LPC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LYNNE
Last Name:DURRETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 JOY DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5376
Mailing Address - Country:US
Mailing Address - Phone:986-768-6136
Mailing Address - Fax:
Practice Address - Street 1:1258 BROWNSWITCH RD STE CANDD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-1605
Practice Address - Country:US
Practice Address - Phone:985-768-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8221101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor