Healthcare Provider Details

I. General information

NPI: 1891435210
Provider Name (Legal Business Name): VALERIE ANNE DUQUETTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HEALTH PARK BLVD STE 212
ST AUGUSTINE FL
32086-5797
US

IV. Provider business mailing address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5790
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-4040
  • Fax: 904-819-4041
Mailing address:
  • Phone: 904-819-5155
  • Fax: 904-819-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW10627
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: