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General NPI Number Information
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NPI Number | 1205996469
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Entity Type | Individual
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Provider Name | MATTHEW IVAN DUCKETT LMFT
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 15001 E OXFORD AVE
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City | AURORA
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State | CO
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Zip | 80014-4191
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Country | US
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Telephone | 720-808-0991
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 N SHERMAN ST #306
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City | DENVER
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State | CO
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Zip | 80203-2816
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Country | US
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Telephone | 720-636-6283
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF 49501
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0001216
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License Number State | CO
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