Provider Demographics
NPI:1962568303
Name:DUNCAN, BRENT LEROY (LCSW)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:LEROY
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 W 1750 S
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2185
Mailing Address - Country:US
Mailing Address - Phone:435-225-0163
Mailing Address - Fax:
Practice Address - Street 1:514 MEDICAL DRIVE
Practice Address - Street 2:SUITE B100
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010
Practice Address - Country:US
Practice Address - Phone:435-225-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5566976-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical