Provider Demographics
NPI:1194835140
Name:LAWRENCE E CURRIE PHD SC
Entity Type:Organization
Organization Name:LAWRENCE E CURRIE PHD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CURRIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-354-3089
Mailing Address - Street 1:PO BOX 240164
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-9008
Mailing Address - Country:US
Mailing Address - Phone:414-354-3089
Mailing Address - Fax:
Practice Address - Street 1:6815 W CAPITOL DR STE 203
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2056
Practice Address - Country:US
Practice Address - Phone:414-354-3809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI531057103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI344423582E01OtherBLUE CROSS BLUE SHIELD
WI39057000Medicaid
R39441Medicare UPIN