Healthcare Provider Details

I. General information

NPI: 1437416104
Provider Name (Legal Business Name): SUSAN LEIGH CURTIS LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 11/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131C MAIN ST
EPPING NH
03042-2428
US

IV. Provider business mailing address

131C MAIN ST
EPPING NH
03042-2428
US

V. Phone/Fax

Practice location:
  • Phone: 36-693-6265
  • Fax: 603-693-6265
Mailing address:
  • Phone: 36-693-6265
  • Fax: 603-693-6265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number869
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: