Coretta Durant
Individual provider Active NPI Homemaker · Columbia, SC
NPI 1427604115 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1427604115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 645 Pine Lilly Dr
Columbia, SC 29229-7079 - Phone
- (803) 886-0908
- NPI assigned
- Aug 17, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Homemaker | 376J00000X | Yes |
Addresses
Primary practice location
645 Pine Lilly Dr
Columbia, SC 29229-7079
Mailing address
645 Pine Lilly Dr
Columbia, SC 29229-7079
Phone (803) 886-0908
Other practice location 1
421 Fayetteville St Ste 1100
Raleigh, NC 27601
Phone (877) 418-2978
Other practice location 2
421 Fayetteville St Ste 1100
Raleigh, NC 27601
Phone (877) 418-2978
Other practice location 3
500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (877) 418-2978
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.