Provider Demographics
NPI:1033664784
Name:DUFFEY, JOHN MICHAEL I (ABD, MACC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:DUFFEY
Suffix:I
Gender:M
Credentials:ABD, MACC
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:MICHAEL
Other - Last Name:DUFFEY
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:MAC, NCC, LPC
Mailing Address - Street 1:5009 RIVERCHASE DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-7497
Mailing Address - Country:US
Mailing Address - Phone:334-408-4689
Mailing Address - Fax:334-408-2100
Practice Address - Street 1:5009 RIVERCHASE DR STE 100A
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-7497
Practice Address - Country:US
Practice Address - Phone:334-408-4689
Practice Address - Fax:334-408-2100
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
AL3406101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)