Provider Demographics
NPI:1467789917
Name:DUNCAN, LA SHONDA SIMS (MFT,LPC,LPCC-S,NCC)
Entity Type:Individual
Prefix:MRS
First Name:LA SHONDA
Middle Name:SIMS
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MFT,LPC,LPCC-S,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 BARDSTOWN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4271
Mailing Address - Country:US
Mailing Address - Phone:502-936-6546
Mailing Address - Fax:502-242-1984
Practice Address - Street 1:4229 BARDSTOWN RD STE 204
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-936-6546
Practice Address - Fax:502-242-1984
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8868101YM0800X
KY163130101YM0800X
KYLPCPCC00218312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104858Medicaid