Provider Demographics
NPI:1629166418
Name:DUCLOS, STEPHEN C (LMFT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:C
Last Name:DUCLOS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 HARBORVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-1213
Mailing Address - Country:US
Mailing Address - Phone:781-925-2847
Mailing Address - Fax:617-745-4170
Practice Address - Street 1:1354 HANCOCK ST
Practice Address - Street 2:SUITE 304
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5109
Practice Address - Country:US
Practice Address - Phone:617-745-4100
Practice Address - Fax:617-745-4170
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1293106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist