Healthcare Provider Details

I. General information

NPI: 1649595505
Provider Name (Legal Business Name): LASUNA M CURRY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 N MARKET ST
CHARLESTON MS
38921-1524
US

IV. Provider business mailing address

PO BOX 331
CLARKSDALE MS
38614-0331
US

V. Phone/Fax

Practice location:
  • Phone: 662-647-0099
  • Fax: 662-627-5240
Mailing address:
  • Phone: 662-627-7267
  • Fax: 662-627-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: