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NPI Code Detail

MEDICARE: DR. KENNETH GRANT MCCURDY PH.D.

MEDICARE: DR. KENNETH GRANT MCCURDY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorE2829OH
2101YM0800XMental Health Counselor3497-1NY
3101YP2500XProfessional CounselorPC003420PA

General Provider Information

NPI Number : 1013102474
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH GRANT MCCURDY PH.D.
Provider Business Mailing Address
First Line : 109 UNIVERSITY SQUARE
Second Line : GANNON UNIVERSITY PSYCHOLOGY DEPT.
City : ERIE
State : PA
Zip : 16541-0001
Country : US
Telephone Number : 814-871-7791
Fax Number : 814-871-5511
Provider Business Practice Location Address
First Line : 109 UNIVERSITY SQUARE
Second Line : PSYCHOLOGY DEPT., GANNON UNIVERSITY
City : ERIE
State : PA
Zip : 16541-0001
Country : US
Telephone Number : 814-871-7791
Fax Number : 814-871-5511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2007
Last Update Date : 09/10/2007

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