Healthcare Provider Details

I. General information

NPI: 1750194635
Provider Name (Legal Business Name): BRUCE MICHAEL CURRY JR. LMLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 05/15/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3103 N MICHIGAN ST
PITTSBURG KS
66762-2545
US

IV. Provider business mailing address

911 E CENTENNIAL DR
PITTSBURG KS
66762-6601
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-5130
  • Fax: 620-235-7171
Mailing address:
  • Phone: 620-231-5130
  • Fax: 620-235-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number03410
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: