Provider Demographics
NPI:1780830125
Name:DUNCAN, BENJAMIN CARL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:CARL
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:B.
Other - Middle Name:CARL
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:PO BOX 31001-0698
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-0698
Mailing Address - Country:US
Mailing Address - Phone:602-263-1518
Mailing Address - Fax:602-263-1625
Practice Address - Street 1:4212 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5319
Practice Address - Country:US
Practice Address - Phone:602-263-1518
Practice Address - Fax:602-263-1625
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-064911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical