Provider Demographics
NPI:1508998113
Name:DUNCAN, BRIAN K (MA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 PINON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2420
Mailing Address - Country:US
Mailing Address - Phone:719-351-5293
Mailing Address - Fax:719-355-1789
Practice Address - Street 1:1330 QUAIL LAKE LOOP
Practice Address - Street 2:STE. 240
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4651
Practice Address - Country:US
Practice Address - Phone:719-640-5445
Practice Address - Fax:719-355-1789
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3842101YP2500X
CO5521101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5521OtherCACII
CO3842OtherLPC