Provider Demographics
NPI:1891113023
Name:DUNCAN, TAI (LMHC)
Entity Type:Individual
Prefix:
First Name:TAI
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-1768
Mailing Address - Country:US
Mailing Address - Phone:574-314-6446
Mailing Address - Fax:574-314-6446
Practice Address - Street 1:304 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1768
Practice Address - Country:US
Practice Address - Phone:574-314-6446
Practice Address - Fax:574-314-6446
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN39002975A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health