Jennifer Nicole Duvall, MSSW, LSW
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Charlestown, IN
NPI 1003312463 · NPPES record last updated Apr 23, 2024
Key facts
- NPI
- 1003312463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 33009095A (IN)
- Practice address
- 7509 Charlestown Pike
Charlestown, IN 47111-9623 - Phone
- (812) 256-4686
- Fax
- (812) 256-4415
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33009095A | IN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 33009095A | IN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 33009095A | IN | Yes |
Addresses
Primary practice location
7509 Charlestown Pike
Charlestown, IN 47111-9623
Mailing address
705 E 7TH St
Jeffersonville, IN 47130-4101
Phone (502) 387-2292
Other practice location 1
2820 Grant Line Rd
New Albany, IN 47150-2494
Phone (812) 981-2594 ext. 1919
Other names
- Mrs. Jennifer Nicole Goretcki
Other providers in Charlestown, IN
- Kristen Devore
- Alexandra Kay Dilger
- Sherilenna Kay Disney
- Krystia Dodge
- Deborah Durbin
- Cassandra Ann Edelmann
- Empowerme Wellness Kansas City, LLC
- Jennifer Ennis
- Sean Gregory Evans
- Traci Lyn Falbo
All providers in Charlestown, IN · Addiction (Substance Use Disorder) Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.