Provider Demographics
NPI:1649913559
Name:WATFORD, CURTIS DUANE (MA, LPC)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:DUANE
Last Name:WATFORD
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 SCOTT AVE STE 1108
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2616
Mailing Address - Country:US
Mailing Address - Phone:940-613-1661
Mailing Address - Fax:940-228-0424
Practice Address - Street 1:719 SCOTT AVE STE 1108
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2616
Practice Address - Country:US
Practice Address - Phone:940-613-1661
Practice Address - Fax:940-228-0424
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional