Provider Demographics
NPI:1689246738
Name:CURRY, STORMIE (CDCA)
Entity Type:Individual
Prefix:
First Name:STORMIE
Middle Name:
Last Name:CURRY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 HILL RD
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:OH
Mailing Address - Zip Code:43821
Mailing Address - Country:US
Mailing Address - Phone:740-575-5672
Mailing Address - Fax:740-693-4157
Practice Address - Street 1:215 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6220
Practice Address - Country:US
Practice Address - Phone:740-899-4005
Practice Address - Fax:740-899-4023
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH176322171M00000X
OH181045171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0433742Medicaid