Provider Demographics
NPI:1154864197
Name:DUNCAN, MICHELLE K (LICDC, LISW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:K
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LICDC, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 N COLUMBUS ST STE G
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8408
Mailing Address - Country:US
Mailing Address - Phone:740-901-1231
Mailing Address - Fax:740-901-3021
Practice Address - Street 1:2670 N COLUMBUS ST STE G
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8408
Practice Address - Country:US
Practice Address - Phone:740-901-1231
Practice Address - Fax:740-901-3021
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-23
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101110101YA0400X
OH18013041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)