Provider Demographics
NPI:1356791172
Name:DUNCAN, RICKY LEE (LCSW)
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:LEE
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3751 SW DURHAM DR APT 106
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3264
Mailing Address - Country:US
Mailing Address - Phone:434-426-6708
Mailing Address - Fax:
Practice Address - Street 1:3751 SW DURHAM DR APT 106
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3264
Practice Address - Country:US
Practice Address - Phone:434-426-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040109011041C0700X
NCP0103671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical