Provider Demographics
NPI:1306229240
Name:CURTIS, ANGELA M (MC, LPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 W WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-8364
Mailing Address - Country:US
Mailing Address - Phone:480-274-5910
Mailing Address - Fax:
Practice Address - Street 1:1255 W BASELINE RD STE B138
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5820
Practice Address - Country:US
Practice Address - Phone:480-820-5422
Practice Address - Fax:480-775-4938
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16317101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional