Provider Demographics
NPI:1902560071
Name:DURNING, MARY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DURNING
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 ST. JOHN'S LANE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ELLICOT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-750-2970
Mailing Address - Fax:410-480-0110
Practice Address - Street 1:3355 ST. JOHN'S LANE
Practice Address - Street 2:SUITE F
Practice Address - City:ELLICOT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-750-2970
Practice Address - Fax:410-480-0110
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD058101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical