Provider Demographics
NPI:1013102474
Name:MCCURDY, KENNETH GRANT (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:GRANT
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 UNIVERSITY SQUARE
Mailing Address - Street 2:GANNON UNIVERSITY PSYCHOLOGY DEPT.
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16541-0001
Mailing Address - Country:US
Mailing Address - Phone:814-871-7791
Mailing Address - Fax:814-871-5511
Practice Address - Street 1:109 UNIVERSITY SQUARE
Practice Address - Street 2:PSYCHOLOGY DEPT., GANNON UNIVERSITY
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16541-0001
Practice Address - Country:US
Practice Address - Phone:814-871-7791
Practice Address - Fax:814-871-5511
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2829101YM0800X
NY3497-1101YM0800X
PAPC003420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health