Healthcare Provider Details

I. General information

NPI: 1962841585
Provider Name (Legal Business Name): CYNTHIA CURATALO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26419 MAPLE DR
SHELL KNOB MO
65747-7481
US

IV. Provider business mailing address

26419 MAPLE DR
SHELL KNOB MO
65747-7481
US

V. Phone/Fax

Practice location:
  • Phone: 808-895-6623
  • Fax: 417-895-9053
Mailing address:
  • Phone: 808-895-6623
  • Fax: 417-895-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6879-C
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3823
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2013009768
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: