MEDICARE: VALERIE ANNE DUQUETTE 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
1	1041C0700X	Clinical Social Worker	SW10627	FL

General Provider Information

NPI Number	:	1891435210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE ANNE DUQUETTE LCSW

Provider Business Mailing Address
First Line	:	400 HEALTH PARK BLVD
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-5790
Country	:	US
Telephone Number	:	904-819-5155
Fax Number	:	904-819-4906

Provider Business Practice Location Address
First Line	:	201 HEALTH PARK BLVD STE 212
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-5797
Country	:	US
Telephone Number	:	904-819-4040
Fax Number	:	904-819-4041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	07/22/2022

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