Provider Demographics
NPI:1417164500
Name:DUNCAN, DENISE (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREENWAY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-3400
Mailing Address - Country:US
Mailing Address - Phone:631-807-3757
Mailing Address - Fax:631-750-2219
Practice Address - Street 1:312 EXPRESSWAY DR S
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-2555
Practice Address - Country:US
Practice Address - Phone:631-750-2223
Practice Address - Fax:631-750-2219
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health