Provider Demographics
NPI:1710430681
Name:JOHN CURTIN, LMHC LLC
Entity Type:Organization
Organization Name:JOHN CURTIN, LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-488-5428
Mailing Address - Street 1:3239 EGRETS LANDING DR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-7420
Mailing Address - Country:US
Mailing Address - Phone:407-488-5428
Mailing Address - Fax:407-688-7205
Practice Address - Street 1:205 WAYMONT CT
Practice Address - Street 2:SUITE 111
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3593
Practice Address - Country:US
Practice Address - Phone:407-488-5428
Practice Address - Fax:407-688-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7628101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017651900Medicaid