Provider Demographics
NPI:1679165146
Name:DUCLOS PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:DUCLOS PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DUCLOS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:785-273-7292
Mailing Address - Street 1:3441 SW HUNTOON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1745
Mailing Address - Country:US
Mailing Address - Phone:785-554-6311
Mailing Address - Fax:
Practice Address - Street 1:5847 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2462
Practice Address - Country:US
Practice Address - Phone:785-273-7292
Practice Address - Fax:785-273-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty