Malissa Elaine Duckworth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5757 Issued in TN

Practice address

711 Jefferson Ave
Memphis, TN 38105-5003

Phone

(901) 448-6598

NPI assigned

Aug 15, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1487087284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 WINGFIELD RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381222420",
            "telephone_number": "901-268-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055003",
            "telephone_number": "901-448-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "MALISSA",
        "middle_name": "ELAINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duckworth Pathology Group Reference Lab
• Duckworth Pathology Group, Inc.
• Duckworth Pathology Group, Inc.
• Cody Raine Duckworth, PSY.D.
• Jeremy Duckworth
• Mary A Duckworth, B.A.
• Nancy H Duckworth, M.D.
• Savannah Kaye Duckworth
• Andrew Dudas, MD
• Paul Daniel Duesing, MD

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.