Provider Demographics
NPI:1689922841
Name:DUKE, JANE SHARER (MCOUN,LCPC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:SHARER
Last Name:DUKE
Suffix:
Gender:F
Credentials:MCOUN,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6126 W STATE ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-2741
Mailing Address - Country:US
Mailing Address - Phone:208-866-9584
Mailing Address - Fax:208-853-0939
Practice Address - Street 1:10257 N PALISADES WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83714-9503
Practice Address - Country:US
Practice Address - Phone:208-939-5866
Practice Address - Fax:208-853-0939
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC #162101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional