Provider Demographics
NPI:1255797437
Name:SPICER, DUEWA (LICSW, LMSW)
Entity type:Individual
Prefix:
First Name:DUEWA
Middle Name:
Last Name:SPICER
Suffix:
Gender:F
Credentials:LICSW, LMSW
Other - Prefix:
Other - First Name:KAYA
Other - Middle Name:
Other - Last Name:SPICER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:1337 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3094
Mailing Address - Country:US
Mailing Address - Phone:202-321-9715
Mailing Address - Fax:
Practice Address - Street 1:1337 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3094
Practice Address - Country:US
Practice Address - Phone:202-321-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500820091041C0700X
MD21355104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1255797437OtherNPI