Provider Demographics
NPI:1407240146
Name:DUCLAIR, TAMICA JANAY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMICA
Middle Name:JANAY
Last Name:DUCLAIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TAMICA
Other - Middle Name:JANAY
Other - Last Name:ARMSTEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:431 HUDSON AVE.
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-4503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:431 HUDSON AVE.
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-4503
Practice Address - Country:US
Practice Address - Phone:516-232-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092204104100000X
090606-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker