Provider Demographics
NPI:1144726233
Name:MAD DURPETTI LTD
Entity type:Organization
Organization Name:MAD DURPETTI LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DURPETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:331-222-6410
Mailing Address - Street 1:8 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4401
Mailing Address - Country:US
Mailing Address - Phone:331-222-6410
Mailing Address - Fax:
Practice Address - Street 1:12 1/2 WALL ST STE N
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2732
Practice Address - Country:US
Practice Address - Phone:331-222-6410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health