Provider Demographics
NPI:1235776931
Name:DUKES, EBONY PRESHETTE (BSW)
Entity type:Individual
Prefix:MS
First Name:EBONY
Middle Name:PRESHETTE
Last Name:DUKES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 POST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-2145
Mailing Address - Country:US
Mailing Address - Phone:585-503-1683
Mailing Address - Fax:
Practice Address - Street 1:1645 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3162
Practice Address - Country:US
Practice Address - Phone:585-546-7220
Practice Address - Fax:585-546-2607
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health