Provider Demographics
NPI:1649540956
Name:DUNCAN, LORI K (LADC)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:K
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:K
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LADC
Mailing Address - Street 1:4728 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2440
Mailing Address - Country:US
Mailing Address - Phone:402-812-8817
Mailing Address - Fax:
Practice Address - Street 1:4728 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2440
Practice Address - Country:US
Practice Address - Phone:402-453-5656
Practice Address - Fax:402-455-1811
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE808101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)