Provider Demographics
NPI:1376202713
Name:CURTIS, LAURA (LICSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 ADAMS ST # 312
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4841
Mailing Address - Country:US
Mailing Address - Phone:507-254-8676
Mailing Address - Fax:
Practice Address - Street 1:20202 INDIAN LAKE RD
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6609
Practice Address - Country:US
Practice Address - Phone:507-254-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN262841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical