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General NPI Number Information
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NPI Number | 1598886566
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Entity Type | Individual
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Provider Name | ZITA MARIE DUFFY MSW, LISW-S, CSW
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 2410 GRAPE RD
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City | MISHAWAKA
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State | IN
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Zip | 46545-3015
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Country | US
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Telephone | 574-217-0128
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Fax | 574-288-3447
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Provider Business Mailing Address
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Address Line | 10100 ELIDA RD
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City | DELPHOS
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State | OH
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Zip | 45833-9058
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Country | US
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Telephone | 800-532-7239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 34008946A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I0009486-SUPV
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34008946A
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License Number State | IN
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