Healthcare Provider Details

I. General information

NPI: 1821329053
Provider Name (Legal Business Name): GLENDA B DUNCAN ACSW, LCSW, MAC, CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 DARNALL LOOP HEADQUARTERS, CARL R. DARNALL MEDICAL CENTER
FORT HOOD TX
76544
US

IV. Provider business mailing address

3 CAMPUS ST
CURLEW WA
99118-9601
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8443
  • Fax: 254-286-7188
Mailing address:
  • Phone: 509-779-0652
  • Fax: 509-779-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1838
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP 00006214
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: