Provider Demographics
NPI:1336540525
Name:KING-DUNCAN, SUSIE (LMSW)
Entity type:Individual
Prefix:
First Name:SUSIE
Middle Name:
Last Name:KING-DUNCAN
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 1:12278 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70811-1035
Mailing Address - Country:US
Mailing Address - Phone:225-364-9428
Mailing Address - Fax:225-341-6797
Practice Address - Street 1:12278 PLANK RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70811-1035
Practice Address - Country:US
Practice Address - Phone:225-364-9428
Practice Address - Fax:225-341-6797
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker