Active NPI
Stephanie Diane Durham, LPC
- Professional Counselor
- Granbury, TX
National Provider Identifier
1386319457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 80725
- Practice address
- 1112 Sunset Bay Dr
Granbury, TX 76048-1240 - Phone
- (254) 913-7229
- NPI assigned
- Aug 11, 2021
- Last updated
- Aug 11, 2021
- 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 | 80725 | TX | Primary |
Addresses
Primary practice location
1112 Sunset Bay Dr
Granbury, TX 76048-1240
Mailing address
1112 Sunset Bay Dr
Granbury, TX 76048-1240
Phone (254) 913-7229
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 |
|---|---|---|---|
| 80725 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1386319457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 SUNSET BAY DR",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760481240",
"telephone_number": "254-913-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 SUNSET BAY DR",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760481240",
"telephone_number": "254-913-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "STEPHANIE",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-11",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "80725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.