Provider Demographics
NPI:1558554766
Name:CURTAS, THERESA (PSYD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:CURTAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10381 STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3216
Mailing Address - Country:US
Mailing Address - Phone:703-255-0635
Mailing Address - Fax:
Practice Address - Street 1:9300 DEWITT LOOP, RIVER PAVILION, 2ND FLOOR
Practice Address - Street 2:FORT BELVOIR COMMUNITY HOSPITAL
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060
Practice Address - Country:US
Practice Address - Phone:571-231-3224
Practice Address - Fax:571-231-1283
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004205103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD58956180Medicaid
MD941L70Medicare PIN