Provider Demographics
NPI:1336711514
Name:CURTIS, ELEANOR SULLIVAN (LCSW-A)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:SULLIVAN
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TABERNA CIR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-7039
Mailing Address - Country:US
Mailing Address - Phone:910-554-2239
Mailing Address - Fax:
Practice Address - Street 1:201 TABERNA CIR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-7039
Practice Address - Country:US
Practice Address - Phone:910-554-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0137261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical