Active NPI
Mary Durand, LPC
- Professional Counselor
- Greenfield, WI
National Provider Identifier
1336690353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6137-125
- Practice address
- 10777 W Beloit Rd
Greenfield, WI 53228-1225 - Phone
- (414) 404-5090
- NPI assigned
- Oct 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6137-125 | WI | Primary |
Addresses
Primary practice location
10777 W Beloit Rd
Greenfield, WI 53228-1225
Mailing address
4542 W Midland Dr
Milwaukee, WI 53219-4840
Phone (262) 716-4869
Other practice location 1
5555 N Port Washington Rd Suite 207
Glendale, WI 53217
Phone (877) 300-9101
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Greenfield | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6137-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grey Matters Counseling LLC | Current | Accepting new patients | |
| Rawhide Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Elm Grove, WI
- NPI 1235751181
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New London, WI
- NPI 1841334620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589587200000",
"number": "1336690353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4542 W MIDLAND DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532194840",
"telephone_number": "262-716-4869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10777 W BELOIT RD",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532281225",
"telephone_number": "414-404-5090"
}
],
"practiceLocations": [
{
"address_1": "5555 N Port Washington Rd Suite 207",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "WI",
"postal_code": "53217",
"country_code": "US",
"telephone_number": "877-300-9101",
"fax_number": "920-982-5054",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DURAND",
"first_name": "MARY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-14",
"last_updated": "2020-05-16",
"certification_date": "2020-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6137-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Greenfield",
"affiliation": "N",
"endpointDescription": "graymatterscounselingllc.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "10777 W Beloit Rd",
"city": "Greenfield",
"state": "WI",
"country_code": "US",
"postal_code": "532281225",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.