Provider Demographics
NPI:1972642957
Name:DUNCAN, GALEN RASHARD (PHD, MSW)
Entity Type:Individual
Prefix:DR
First Name:GALEN
Middle Name:RASHARD
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2854 KEELEY CT
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2678
Mailing Address - Country:US
Mailing Address - Phone:313-282-9610
Mailing Address - Fax:
Practice Address - Street 1:552 GULLEN MALL
Practice Address - Street 2:WAYNE STATE UNIVERSITY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-577-9317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801071245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health