Provider Demographics
NPI:1114046752
Name:CURTIS, GENESE N (PLMHP)
Entity type:Individual
Prefix:
First Name:GENESE
Middle Name:N
Last Name:CURTIS
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-4605
Mailing Address - Country:US
Mailing Address - Phone:402-733-2657
Mailing Address - Fax:
Practice Address - Street 1:115 S 46TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3229
Practice Address - Country:US
Practice Address - Phone:402-553-6000
Practice Address - Fax:402-553-2428
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health