Provider Demographics
NPI:1134995152
Name:DUNCAN, MARISSA ALEXANDRA (LPC)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:ALEXANDRA
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:262-427-8905
Mailing Address - Fax:
Practice Address - Street 1:1317 W GRAND AVE STE 6
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-2075
Practice Address - Country:US
Practice Address - Phone:262-427-8905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11237-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional