Provider Demographics
NPI:1174914642
Name:DUNCAN, JARHAL
Entity type:Individual
Prefix:
First Name:JARHAL
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 340147
Mailing Address - Street 2:3541 DAYTON XENIA RD
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2824
Mailing Address - Country:US
Mailing Address - Phone:937-424-7335
Mailing Address - Fax:
Practice Address - Street 1:3095 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1983
Practice Address - Country:US
Practice Address - Phone:937-293-8300
Practice Address - Fax:937-534-1347
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS15000261041C0700X
OHI.19015621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical