Healthcare Provider Details

I. General information

NPI: 1396334959
Provider Name (Legal Business Name): MRS. TRACIE JAINE DUNCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. TRACIE JAINE SHERER

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39531 GARFIELD RD
CLINTON TWP MI
48038-4300
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 248-677-1890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451022583
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401224972
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401224972
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: