Provider Demographics
NPI:1689006330
Name:CHARLENE CURTIS LCSW LLC
Entity Type:Organization
Organization Name:CHARLENE CURTIS LCSW LLC
Other - Org Name:CHARLENE CURTIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-672-0344
Mailing Address - Street 1:109 PONEMAH ROAD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031
Mailing Address - Country:US
Mailing Address - Phone:603-672-0344
Mailing Address - Fax:603-672-0344
Practice Address - Street 1:109 PONEMAH RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2834
Practice Address - Country:US
Practice Address - Phone:603-672-0344
Practice Address - Fax:603-672-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty