Provider Demographics
NPI:1629111042
Name:SPILDE, DUANE (LCSWR, ACSW)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:
Last Name:SPILDE
Suffix:
Gender:M
Credentials:LCSWR, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL RD.
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1454
Mailing Address - Country:US
Mailing Address - Phone:607-865-6522
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL RD.
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1454
Practice Address - Country:US
Practice Address - Phone:607-865-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR017322-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical