Provider Demographics
NPI:1609895697
Name:DUNCAN, ELAINE M (LPC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6214 INNES TRACE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6009
Mailing Address - Country:US
Mailing Address - Phone:502-425-5722
Mailing Address - Fax:502-241-6811
Practice Address - Street 1:6200 CRESTWOOD STA
Practice Address - Street 2:SUITE A
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-7418
Practice Address - Country:US
Practice Address - Phone:502-241-2909
Practice Address - Fax:502-241-6811
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY0217OtherSTATE LICENSE NUMBER