Provider Demographics
NPI:1689936759
Name:DUNCAN, AJA (LPC)
Entity Type:Individual
Prefix:
First Name:AJA
Middle Name:
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 1:201 WOOD THRUSH WAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-5335
Mailing Address - Country:US
Mailing Address - Phone:864-660-9262
Mailing Address - Fax:844-444-1152
Practice Address - Street 1:201 WOOD THRUSH WAY
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-5335
Practice Address - Country:US
Practice Address - Phone:864-660-9262
Practice Address - Fax:844-444-1152
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002578101YA0400X
SC6295101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1632Medicaid