Healthcare Provider Details

I. General information

NPI: 1043648454
Provider Name (Legal Business Name): DUANE ANTHONY HALBUR JR. PHD, NCC, LMHC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 SALEM CT
BETTENDORF IA
52722
US

IV. Provider business mailing address

2420 SALEM CT
BETTENDORF IA
52722-3138
US

V. Phone/Fax

Practice location:
  • Phone: 706-726-9593
  • Fax:
Mailing address:
  • Phone: 706-726-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.0142
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00742
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: