Provider Demographics
NPI:1376819276
Name:DUFF, ERIC TOWLE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:TOWLE
Last Name:DUFF
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 PASEO DE LOS PUEBLOS APT 20
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-0495
Mailing Address - Country:US
Mailing Address - Phone:707-407-6891
Mailing Address - Fax:
Practice Address - Street 1:2838 PASEO DE LOS PUEBLOS APT 20
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-0495
Practice Address - Country:US
Practice Address - Phone:707-407-6891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 14759101YM0800X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical