MEDICARE: MS. SANDRA LOUISE DUNCAN-HARDIN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39001122A	IN

General Provider Information

NPI Number	:	1164605895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA LOUISE DUNCAN-HARDIN LMHC

Provider Business Mailing Address
First Line	:	909 LAKEVIEW DR
Second Line	:
City	:	LOGANSPORT
State	:	IN
Zip	:	46947-2208
Country	:	US
Telephone Number	:	574-732-1166
Fax Number	:	574-753-4117

Provider Business Practice Location Address
First Line	:	1950 W 86TH ST
Second Line	:	SUITE 202
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2076
Country	:	US
Telephone Number	:	317-824-1725
Fax Number	:	317-824-0725

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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