| Doctor Name: | JONATHAN D. DURST |
| NPI Number: | 1215067590 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.M.H.C., N.C.C. |
| License Number: | 231125 |
| Business Practice Address: | 8130 Oswego Rd Suite 1 Liverpool, NY - 130901520 |
| Business Phone Number: | 3156520000 |
| Business Fax Number: | 3156522736 |
| Mailing Address: | 20 Stoutenger Rd, PHOENIX |
| State: | NY |
| Postal Code: | 131352182 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 06/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 231125 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |