Provider Demographics
NPI:1407502800
Name:CURTIS, LYSBETH KRYSTYNA (LMFT)
Entity Type:Individual
Prefix:
First Name:LYSBETH
Middle Name:KRYSTYNA
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SERENITY
Other - Middle Name:K
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:730 E 38TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-5235
Mailing Address - Country:US
Mailing Address - Phone:612-712-3417
Mailing Address - Fax:
Practice Address - Street 1:730 E 38TH ST STE 205
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-5235
Practice Address - Country:US
Practice Address - Phone:612-712-3417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3774106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty