Provider Demographics
NPI:1124531785
Name:DEL DUCA, JAMES MARION III (LAC-CANDIDATE)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MARION
Last Name:DEL DUCA
Suffix:III
Gender:M
Credentials:LAC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HAGGERTY LN STE 2
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-1780
Mailing Address - Country:US
Mailing Address - Phone:406-599-2463
Mailing Address - Fax:
Practice Address - Street 1:333 HAGGERTY LN STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-1780
Practice Address - Country:US
Practice Address - Phone:406-599-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 101Y00000X, 102L00000X
MTBBH-ACLC-LIC-14219101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst