Provider Demographics
NPI:1497231070
Name:DUFFY, ERIKA ACKERMANN (LICSW)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ACKERMANN
Last Name:DUFFY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-1853
Mailing Address - Country:US
Mailing Address - Phone:781-439-9912
Mailing Address - Fax:
Practice Address - Street 1:BEEMAN ELEMENTARY SCHOOL
Practice Address - Street 2:138 CHERRY STREET
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930
Practice Address - Country:US
Practice Address - Phone:978-281-9825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1105461041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool