Provider Demographics
NPI:1265518641
Name:CURTISS, SUSAN R (LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:R
Last Name:CURTISS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MYSTIC AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4632
Mailing Address - Country:US
Mailing Address - Phone:781-396-1199
Mailing Address - Fax:781-396-1439
Practice Address - Street 1:90 NEW STATE HWY STE 6
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5461
Practice Address - Country:US
Practice Address - Phone:508-880-6868
Practice Address - Fax:508-880-6848
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health