Provider Demographics
NPI:1790359297
Name:CURT WIEDEY MSW LCSW LLC
Entity Type:Organization
Organization Name:CURT WIEDEY MSW LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WIEDEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-633-4077
Mailing Address - Street 1:3225 TEMPLETON GAP RD STE 218
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8714
Mailing Address - Country:US
Mailing Address - Phone:719-633-4077
Mailing Address - Fax:719-520-5976
Practice Address - Street 1:3225 TEMPLETON GAP RD STE 218
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8714
Practice Address - Country:US
Practice Address - Phone:719-633-4077
Practice Address - Fax:719-520-5976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty