Basic Information
| Provider Information | |||||||||
| NPI: | 1639229248 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | SUE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 BIRCH RD | ||||||||
| Address2: | |||||||||
| City: | MALVERN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193551605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848865142 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 BLACKHORSE HILL RD | ||||||||
| Address2: | |||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193202040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW015970 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 20615 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.