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NPI Code Detail

MEDICARE: DUKEN MARVELLY LCSW-S, LCDC

MEDICARE:   DUKEN  MARVELLY  LCSW-S, LCDC
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) Counselor12891TX
21041C0700XClinical Social Worker56903TX
31041C0700XClinical Social Worker17623LA
4104100000XSocial Worker56903TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245633908
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUKEN MARVELLY LCSW-S, LCDC
Provider Business Mailing Address
First Line : 4606 FM 1960 RD W STE 412
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1369
Country : US
Telephone Number : 832-774-1444
Fax Number :
Provider Business Practice Location Address
First Line : 4606 FM 1960 RD W STE 412
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1369
Country : US
Telephone Number : 832-774-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2014
Last Update Date : 02/18/2026

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Directions to “ DUKEN MARVELLY LCSW-S, LCDC” Practice Location

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