Provider Demographics
NPI:1669415634
Name:DUNCAN, GEORGE R (MSW, LPC)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:R
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 N SAGINAW ST
Mailing Address - Street 2:SUITE G101
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2165
Mailing Address - Country:US
Mailing Address - Phone:248-253-0176
Mailing Address - Fax:248-253-1570
Practice Address - Street 1:91 N. SAGINAW ST.,
Practice Address - Street 2:SUITE G101
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342
Practice Address - Country:US
Practice Address - Phone:248-253-0176
Practice Address - Fax:248-253-1570
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010826271041C0700X
LA8520101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIQ37309Medicare UPIN
MIN71680005Medicare PIN