Provider Demographics
NPI:1427676816
Name:CURTIS, MARY A (LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 JOSSERAND RD
Mailing Address - Street 2:P.O. BOX1264
Mailing Address - City:GROVETON
Mailing Address - State:TX
Mailing Address - Zip Code:75845
Mailing Address - Country:US
Mailing Address - Phone:936-676-7656
Mailing Address - Fax:936-642-2129
Practice Address - Street 1:567 JOSSERAND RD
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-4793
Practice Address - Country:US
Practice Address - Phone:936-676-7656
Practice Address - Fax:936-642-2129
Is Sole Proprietor?:No
Enumeration Date:2020-07-11
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health