Individual provider Active NPI

Marissa Alexandra Duncan, LPC

  • Professional Counselor
  • Port Washington, WI
National Provider Identifier
1134995152
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11237-125 Issued in WI
Practice address
1317 W Grand Ave Ste 6
Port Washington, WI 53074-2075
Phone
(262) 427-8905
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11237-125 WI Primary

Addresses

Primary practice location

1317 W Grand Ave Ste 6
Port Washington, WI 53074-2075

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (262) 427-8905

Other practice location 1

2727 N Grandview Blvd Ste 203
Waukesha, WI 53188-1671
Phone (262) 547-5567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829001472 WI Practitioner - Mental Health Counselor 8022557412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

9809 S Franklin Dr
Suite 302
Franklin, WI 53132-8885
Phone (262) 789-1191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11237-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc Mental Health CurrentSince Oct 12, 2024 Accepting new patients
Family Service Agency of Waukesha County Inc Mental Health CurrentSince Aug 15, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

9809 S Franklin Dr
Ste 302
Franklin, WI 53132
Phone (253) 372-8662

1317 W Grand Ave
Ste 6
Prt Washingtn, WI 53074
Phone (262) 284-8800

1143 Warwick Way
Racine, WI 53406
Phone (262) 321-0110

726 N East Ave
Waukesha, WI 53186
Phone (262) 547-5567

2727 N Grandview Blvd
Ste 203
Waukesha, WI 53188
Phone (262) 547-5567

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1134995152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "262-427-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W GRAND AVE STE 6",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742075",
            "telephone_number": "262-427-8905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 N Grandview Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531881671",
            "country_code": "US",
            "telephone_number": "262-547-5567",
            "fax_number": "262-421-5477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "MARISSA",
        "middle_name": "ALEXANDRA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11237-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, WI

Sources for this page

Verify at the official NPI Registry.