Provider Demographics
NPI:1720226624
Name:DUNCAN, CLARENCE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:
Last Name:DUNCAN
Suffix:
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 1:2855 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8114
Mailing Address - Country:US
Mailing Address - Phone:718-881-8200
Mailing Address - Fax:718-881-8211
Practice Address - Street 1:2855 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8114
Practice Address - Country:US
Practice Address - Phone:718-881-8200
Practice Address - Fax:718-881-8211
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074064-11041C0700X
NY6035101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)