Provider Demographics
NPI:1891038915
Name:CURTIS, LANCE L (LPC)
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:L
Last Name:CURTIS
Suffix:
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 1:1469 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4245
Mailing Address - Country:US
Mailing Address - Phone:330-499-3065
Mailing Address - Fax:330-499-2497
Practice Address - Street 1:1469 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4245
Practice Address - Country:US
Practice Address - Phone:330-499-3065
Practice Address - Fax:330-499-2497
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1100464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional