Provider Demographics
NPI:1649357989
Name:CURLEY, ELLEN E (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:E
Last Name:CURLEY
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 1:20 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3911
Mailing Address - Country:US
Mailing Address - Phone:508-753-2862
Mailing Address - Fax:508-753-1785
Practice Address - Street 1:20 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3911
Practice Address - Country:US
Practice Address - Phone:508-753-2862
Practice Address - Fax:508-753-1785
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10197491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP20259Medicare ID - Type Unspecified