Basic Information
| Provider Information | |||||||||
| NPI: | 1942860408 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KRISTEN LEIGHANNE CURTIS LCSW LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12244 | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974404444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4582094272 | ||||||||
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| Practice Location | |||||||||
| Address1: | 171 LAWRENCE ST | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974012221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4582094272 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2019 | ||||||||
| LastUpdateDate: | 07/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | CURTIS | ||||||||
| AuthorizedOfficialFirstName: | KRISTEN | ||||||||
| AuthorizedOfficialMiddleName: | LEIGHANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4582094272 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.