Provider Demographics
NPI:1023290202
Name:CURTIS, NICOLE M (LPC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:CURTIS
Suffix:
Gender:F
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:PO BOX 1430
Mailing Address - Street 2:HARRISONBURG
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-560-5960
Mailing Address - Fax:540-433-4338
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004282101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1417027608OtherGROUP NPI
VA004945336Medicaid