Provider Demographics
NPI:1225833429
Name:DUQUE, SIMONA ANTONIA (LMSW)
Entity type:Individual
Prefix:
First Name:SIMONA
Middle Name:ANTONIA
Last Name:DUQUE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 SAINT MARKS AVE APT 2H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3726
Mailing Address - Country:US
Mailing Address - Phone:707-845-0848
Mailing Address - Fax:
Practice Address - Street 1:770 SAINT MARKS AVE APT 2H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3726
Practice Address - Country:US
Practice Address - Phone:707-845-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1250581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical