Provider Demographics
NPI:1053455188
Name:DUNCAN, SCOTT P (PHD HSPP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1087
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1087
Mailing Address - Country:US
Mailing Address - Phone:812-471-1591
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:127 N 1000 E
Practice Address - Street 2:
Practice Address - City:CELESTINE
Practice Address - State:IN
Practice Address - Zip Code:47521-9648
Practice Address - Country:US
Practice Address - Phone:812-234-4642
Practice Address - Fax:812-234-7314
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041336A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000185597OtherANTHEM BLUE CROSS BLUE SHIELD
IN200198840BMedicaid
IN149460OtherMEDICARE