=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760768675
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATASHA NICHOLE CURRY L.C.S.W.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2011
-----------------------------------------------------
Last Update Date | 10/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1711 CHURCH ST SUITE D
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23504-2303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-623-8985
-----------------------------------------------------
Fax | 757-623-4516
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1711 CHURCH ST SUITE D
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23504-2303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-623-8985
-----------------------------------------------------
Fax | 757-623-4516
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0904007780
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------