Provider Demographics
NPI:1780720672
Name:SMITH, DUNCAN (PHD ,MSW, LICSW)
Entity type:Individual
Prefix:PROF
First Name:DUNCAN
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD ,MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5731
Mailing Address - Country:US
Mailing Address - Phone:401-286-8747
Mailing Address - Fax:
Practice Address - Street 1:67 SHEFFIELD AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5731
Practice Address - Country:US
Practice Address - Phone:401-305-3468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW012281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical