Provider Demographics
NPI:1114691011
Name:AU, CURTIS REYNOLDS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:REYNOLDS
Last Name:AU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ORCHARD STREET
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570
Mailing Address - Country:US
Mailing Address - Phone:914-400-8935
Mailing Address - Fax:
Practice Address - Street 1:34 ORCHARD STREET
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570
Practice Address - Country:US
Practice Address - Phone:914-400-8935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091326-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty