Provider Demographics
NPI:1194205344
Name:CURETON, MICHELLE TILLMAN (LCMHC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:TILLMAN
Last Name:CURETON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:TILLMAN-CURETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC
Mailing Address - Street 1:5003 S MIAMI BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8589
Mailing Address - Country:US
Mailing Address - Phone:919-354-0840
Mailing Address - Fax:
Practice Address - Street 1:6060 PIEDMONT ROW DR S STE 500
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287-3803
Practice Address - Country:US
Practice Address - Phone:980-326-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14205101YP2500X
NC14205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional