Provider Demographics
NPI:1003281387
Name:CURTIS COUNSELING LLC
Entity Type:Organization
Organization Name:CURTIS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S
Authorized Official - Phone:417-252-1942
Mailing Address - Street 1:2627 STATE ROUTE U
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-3426
Mailing Address - Country:US
Mailing Address - Phone:417-252-1942
Mailing Address - Fax:417-469-0456
Practice Address - Street 1:2627 STATE ROUTE U
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-3426
Practice Address - Country:US
Practice Address - Phone:417-252-1942
Practice Address - Fax:417-469-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004037114101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO491465902Medicaid