MEDICARE: SUSIE KING-DUNCAN LMSW

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	104100000X	Social Worker	8511	LA

General Provider Information

NPI Number	:	1336540525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSIE KING-DUNCAN LMSW

Provider Business Mailing Address
First Line	:	12278 PLANK RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-1035
Country	:	US
Telephone Number	:	225-364-9428
Fax Number	:	225-341-6797

Provider Business Practice Location Address
First Line	:	12278 PLANK RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-1035
Country	:	US
Telephone Number	:	225-364-9428
Fax Number	:	225-341-6797

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

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	10/22/2023

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