Provider Demographics
NPI:1588010136
Name:CURLEY, LAKEISHA MONIQE (AS)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:MONIQE
Last Name:CURLEY
Suffix:
Gender:F
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE PROVIDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:71254-5208
Mailing Address - Country:US
Mailing Address - Phone:318-559-0551
Mailing Address - Fax:318-559-0538
Practice Address - Street 1:1700 LAKE ST
Practice Address - Street 2:
Practice Address - City:LAKE PROVIDENCE
Practice Address - State:LA
Practice Address - Zip Code:71254
Practice Address - Country:US
Practice Address - Phone:318-559-0551
Practice Address - Fax:318-559-0538
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health