MEDICARE: MR. MARK W CURRI LMFT

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
1	106H00000X	Marriage & Family Therapist	CMF0202501	NM

General Provider Information

NPI Number	:	1104916410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK W CURRI LMFT

Provider Business Mailing Address
First Line	:	600 AVENIDA VILLA HERMOSA UNIT 207
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87506-4536
Country	:	US
Telephone Number	:	203-521-4955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 LENA STREET
Second Line	:	BUILDING 'C' , SUITE 3
City	:	SANTA FE
State	:	NM
Zip	:	87505-4536
Country	:	US
Telephone Number	:	203-521-4955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2006
Last Update Date	:	06/11/2020

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