Provider Demographics
NPI:1699001602
Name:SPEARS, CURTIS WAYNE SR (LPC)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:WAYNE
Last Name:SPEARS
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53254
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-3254
Mailing Address - Country:US
Mailing Address - Phone:318-364-7800
Mailing Address - Fax:
Practice Address - Street 1:6169 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71119-8508
Practice Address - Country:US
Practice Address - Phone:318-364-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional