Provider Demographics
NPI:1396384558
Name:DUNCAN, PATRICK (LCSWA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NEW BRIDGE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4736
Mailing Address - Country:US
Mailing Address - Phone:910-336-4958
Mailing Address - Fax:910-333-9742
Practice Address - Street 1:201 NEW BRIDGE ST STE 105
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4736
Practice Address - Country:US
Practice Address - Phone:910-336-4958
Practice Address - Fax:910-333-9742
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP014252104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty