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NPI Code Detail

MEDICARE: MS. LINDA F DUCKWITZ LICSW, LAC

MEDICARE:  MS. LINDA F DUCKWITZ  LICSW, LAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1024ND
2101YM0800XMental Health Counselor814ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
227600OTHERNDBC/BS ND
327599OTHERNDBC/BS ND

General Provider Information

NPI Number : 1124206248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA F DUCKWITZ LICSW, LAC
Provider Business Mailing Address
First Line : PO BOX 398
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335-0398
Country : US
Telephone Number : 701-476-0497
Fax Number : 701-766-4878
Provider Business Practice Location Address
First Line : 816 3RD AVE N
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335-9998
Country : US
Telephone Number : 701-766-4236
Fax Number : 701-766-4878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2008
Last Update Date : 01/31/2008

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Directions to “ MS. LINDA F DUCKWITZ LICSW, LAC” Practice Location

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