Provider Demographics
NPI:1568156693
Name:MITCHELL, DUNCAN FORREST (LMSW)
Entity Type:Individual
Prefix:
First Name:DUNCAN
Middle Name:FORREST
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 W EMERALD ST STE C100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-2058
Mailing Address - Country:US
Mailing Address - Phone:208-321-0160
Mailing Address - Fax:
Practice Address - Street 1:4477 W EMERALD ST STE C100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2058
Practice Address - Country:US
Practice Address - Phone:208-321-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-436371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical