Provider Demographics
NPI:1396211512
Name:CURTIS, JOAN M (LPC-IT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6310
Mailing Address - Country:US
Mailing Address - Phone:608-365-1244
Mailing Address - Fax:
Practice Address - Street 1:416 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6310
Practice Address - Country:US
Practice Address - Phone:608-364-1244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3941-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health