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NPI Code Detail

MEDICARE: TAMICA JANAY DUCLAIR LCSW

MEDICARE:   TAMICA JANAY DUCLAIR  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker092204NY
21041C0700XClinical Social Worker090606-01

General Provider Information

NPI Number : 1407240146
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMICA JANAY DUCLAIR LCSW
Provider Business Mailing Address
First Line : 431 HUDSON AVE.
Second Line :
City : MECHANICSVILLE
State : NY
Zip : 12118-4503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 431 HUDSON AVE.
Second Line :
City : MECHANICSVILLE
State : NY
Zip : 12118-4503
Country : US
Telephone Number : 516-232-6931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2015
Last Update Date : 11/02/2022

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Directions to “ TAMICA JANAY DUCLAIR LCSW” Practice Location

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