Active NPI
Judith Carla Durall, MA
- Professional Counselor
- Johnson City, TN
National Provider Identifier
1508572033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PE1622.
- Practice address
- 123 Bob Jobe Rd
Johnson City, TN 37615-2142 - Phone
- (423) 791-1534
- NPI assigned
- Jan 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | PE1622. | TN | Primary |
Addresses
Primary practice location
123 Bob Jobe Rd
Johnson City, TN 37615-2142
Mailing address
PO Box 8936
Johnson City, TN 37615-0936
Phone (423) 791-1534
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PE1622. | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674777600000",
"number": "1508572033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8936",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376150936",
"telephone_number": "423-791-1534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 BOB JOBE RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376152142",
"telephone_number": "423-791-1534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURALL",
"first_name": "JUDITH",
"middle_name": "CARLA",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-27",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "PE1622.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.