MEDICARE: MR. CURT W WIEDEY LCSW

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	1041C0700X	Clinical Social Worker	601	CO

General Provider Information

NPI Number	:	1639220742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURT W WIEDEY LCSW

Provider Business Mailing Address
First Line	:	3225 TEMPLETON GAP RD STE 218
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8714
Country	:	US
Telephone Number	:	719-633-4077
Fax Number	:	719-520-5976

Provider Business Practice Location Address
First Line	:	3225 TEMPLETON GAP RD STE 218
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8714
Country	:	US
Telephone Number	:	719-633-4077
Fax Number	:	719-520-5976

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	03/28/2022

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