Provider Demographics
NPI:1407523798
Name:MCDUFFIE, MARCUS AARRON SR (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:AARRON
Last Name:MCDUFFIE
Suffix:SR
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 1:2100 GEORGE DIETER DR # 961846
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3815
Mailing Address - Country:US
Mailing Address - Phone:915-257-9484
Mailing Address - Fax:
Practice Address - Street 1:4728 RAMON VEGA LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-1220
Practice Address - Country:US
Practice Address - Phone:915-257-9484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX632581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical