Provider Demographics
NPI:1366632374
Name:CURTIS, MARY (MARY CURTIS, LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MARY CURTIS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 KERNS CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1569
Mailing Address - Country:US
Mailing Address - Phone:317-817-9847
Mailing Address - Fax:
Practice Address - Street 1:2075 KERNS CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-1569
Practice Address - Country:US
Practice Address - Phone:317-817-9847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000302A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health