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General NPI Number Information
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NPI Number | 1528589223
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Entity Type | Organization
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Legal Business Name | JASON DUNCAN LLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 60 E 42ND ST STE 4600
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City | NEW YORK
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State | NY
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Zip | 10165-0006
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Country | US
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Telephone | 914-447-8986
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BALINT DR APT 516
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City | YONKERS
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State | NY
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Zip | 10710-3928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE AND MANAGING MEMBER
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Name | DR. JASON MICHAEL DUNCAN
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Credential | PH.D.
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Telephone | 914-447-8986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 003659
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60602588
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4876
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 021732
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021732
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License Number State | NY
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