Provider Demographics
NPI:1114211430
Name:DUNCAN, JENIFFER (LPC, ATR, CADC I)
Entity Type:Individual
Prefix:MS
First Name:JENIFFER
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LPC, ATR, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SW ALDER ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-3626
Mailing Address - Country:US
Mailing Address - Phone:503-418-5311
Mailing Address - Fax:
Practice Address - Street 1:621 SW ALDER ST
Practice Address - Street 2:SUITE 520
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3626
Practice Address - Country:US
Practice Address - Phone:503-418-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR100313101YA0400X
ORC3022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)