Provider Demographics
NPI:1699575522
Name:DICURCIO, MICHAEL ANTHONY III
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:DICURCIO
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7061 W ARBY AVE.
Mailing Address - Street 2:STE. 170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4464
Mailing Address - Country:US
Mailing Address - Phone:702-485-5515
Mailing Address - Fax:
Practice Address - Street 1:7061 W ARBY AVE.
Practice Address - Street 2:STE. 170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4464
Practice Address - Country:US
Practice Address - Phone:702-485-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician