Bill J Duke

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

LP1881 Issued in MN

Practice address

420 Center Ave Ste 7
Moorhead, MN 56560-1962

Phone

(701) 241-9281

Fax

(701) 298-8321

NPI assigned

May 21, 2007

Last updated

Nov 24, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prof. Bill J Duke Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1710196522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CENTER AVE STE 7",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601962",
            "telephone_number": "701-241-9281",
            "fax_number": "701-298-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CENTER AVE STE 7",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601962",
            "telephone_number": "701-241-9281",
            "fax_number": "701-298-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "BILL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP1881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455056",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "DUKE",
            "middle_name": "J",
            "prefix": "PROF.",
            "credential": "M.A., PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Drake Counseling Services
• Drake Counseling Services, Inc.
• Mary Kathleen Drake, AUD CCCA
• Sarah Drusch
• Sara Dukart, APRN
• Denise M Duke, ED.D., LP
• Kristin Hannah Dukek
• Jacquelyn Dulka, MOT, OTR/L
• Troy Duncan, MSW
• Faith Durham

• Clinical Child & Adolescent Psychologist in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Clinical Child & Adolescent Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.