Provider Demographics
NPI:1992989461
Name:DUCHENE, JOHN Y (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:Y
Last Name:DUCHENE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E MAIN ST
Mailing Address - Street 2:STE. 406
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3636
Mailing Address - Country:US
Mailing Address - Phone:217-398-9066
Mailing Address - Fax:
Practice Address - Street 1:44 E MAIN ST
Practice Address - Street 2:STE. 406
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3636
Practice Address - Country:US
Practice Address - Phone:217-398-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical