Provider Demographics
NPI:1841252947
Name:ARCURI, KATHLEEN S (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:S
Last Name:ARCURI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SHULTZ HOLLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:PA
Mailing Address - Zip Code:17814
Mailing Address - Country:US
Mailing Address - Phone:570-387-1950
Mailing Address - Fax:570-925-2786
Practice Address - Street 1:102 N MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815
Practice Address - Country:US
Practice Address - Phone:570-387-1950
Practice Address - Fax:570-925-2786
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003643L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA183709Medicare ID - Type Unspecified