Provider Demographics
NPI:1962139238
Name:DUNCAN, JEWEL F (LMSW, CAC-AD)
Entity type:Individual
Prefix:MRS
First Name:JEWEL
Middle Name:F
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LMSW, CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 KENILWORTH CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6141
Mailing Address - Country:US
Mailing Address - Phone:443-889-6787
Mailing Address - Fax:
Practice Address - Street 1:1410 CRAIN HWY N
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-9303
Practice Address - Country:US
Practice Address - Phone:443-889-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28284104100000X
MDAC2994101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)