Provider Demographics
NPI:1760834964
Name:CURTIS, CARLA JEANNE (MS, CADC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:JEANNE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W LAKE ST STE 100-10
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1003
Mailing Address - Country:US
Mailing Address - Phone:630-384-9025
Mailing Address - Fax:
Practice Address - Street 1:134 W LAKE ST STE 100-10
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1003
Practice Address - Country:US
Practice Address - Phone:630-384-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)