1396136859 NPI number — TAREN L DUNCAN-FAUCETT MSW, LCSW

Table of content: TAREN L DUNCAN-FAUCETT MSW, LCSW (NPI 1396136859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396136859 NPI number — TAREN L DUNCAN-FAUCETT MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNCAN-FAUCETT
Provider First Name:
TAREN
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396136859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 FULTON ST
Provider Second Line Business Mailing Address:
ATTN: ANNE LAWSON
Provider Business Mailing Address City Name:
LOGANSPORT
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46947-1577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
574-722-5151
Provider Business Mailing Address Fax Number:
574-739-1414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1948 W BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KOKOMO
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46902-6078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-732-2485
Provider Business Practice Location Address Fax Number:
844-684-6185
Provider Enumeration Date:
02/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 34007807A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com