Provider Information for 1417416462
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NATHAN DONALD DUCHESNE LCPC, LPC
Sex: Male
NPI: 1417416462
Last Updated: 2024-07-18
Certification Date: 2024-07-18
Certification Date: 2024-07-18
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1417416462 | ||||||||||||
| Enumeration Date | 2019-03-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 38 BLAKE ST GREENVILLE, SC 29605-4436 United States Phone: 036-703-5823 | Fax: | ||||||||||||
| Primary Practice Address | 30 PATEWOOD DR STE 160 GREENVILLE, SC 29615-6809 United States Phone: 843-501-1099 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 52 CHRISTIAN RIDGE RD 1695 MAIN ST FL 400 | ||||||||||||
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