Provider Demographics
NPI:1881848208
Name:CURTIS, GREGORY (LICSW)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 S BEDFORD ST
Mailing Address - Street 2:SUITE 400 WEST
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-5108
Mailing Address - Country:US
Mailing Address - Phone:781-229-5874
Mailing Address - Fax:781-272-0558
Practice Address - Street 1:67 S BEDFORD ST
Practice Address - Street 2:SUITE 400 WEST
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-5108
Practice Address - Country:US
Practice Address - Phone:781-229-5874
Practice Address - Fax:781-272-0558
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113347101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor