Provider Demographics
NPI:1801028964
Name:DUFFIE, DELORES JEAN (MSW, LCSW-C)
Entity type:Individual
Prefix:MISS
First Name:DELORES
Middle Name:JEAN
Last Name:DUFFIE
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3342 DOLFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7238
Mailing Address - Country:US
Mailing Address - Phone:410-466-2719
Mailing Address - Fax:
Practice Address - Street 1:2138 N FULTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1307
Practice Address - Country:US
Practice Address - Phone:410-466-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD078061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical