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NPI 1033560230

NPI 1033560230 : MONTAREE ELISE MCCURLEY LMFT : TRAVELERS REST, SC

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General NPI Number Information
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    NPI Number           |    1033560230
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    Entity Type          |    Individual 
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    Provider Name        |    MONTAREE ELISE MCCURLEY LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/29/2016
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    Last Update Date     |    10/19/2020
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Provider Practice Location Address
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    Address Line         |    6715 STATE PARK RD 
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    City                 |    TRAVELERS REST
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    State                |    SC
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    Zip                  |    29690-1831
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    Country              |    US
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    Telephone            |    864-221-4815
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9035 HIGHWAY 59 
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    City                 |    LAVONIA
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    State                |    GA
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    Zip                  |    30553-4135
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    Country              |    US
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    Telephone            |    864-221-4815
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    6982
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    License Number State |    SC
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