Provider Demographics
NPI:1316651615
Name:DUQUEN, DANIEL (LMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DUQUEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WYANDANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3919
Mailing Address - Country:US
Mailing Address - Phone:631-617-7845
Mailing Address - Fax:
Practice Address - Street 1:900 WHEELER RD STE 265
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2971
Practice Address - Country:US
Practice Address - Phone:631-365-4454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health