Provider Demographics
NPI:1770875148
Name:DUCH, JOHN CHARLES (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:DUCH
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 TURKEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-2386
Mailing Address - Country:US
Mailing Address - Phone:845-758-4151
Mailing Address - Fax:
Practice Address - Street 1:531 TURKEY HILL RD
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-2386
Practice Address - Country:US
Practice Address - Phone:845-758-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060494-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool