MEDICARE: MR. CURTIS SCOTT PIERCE LLPC

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	101YP2500X	Professional Counselor	6401018290	MI

General Provider Information

NPI Number	:	1700407863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURTIS SCOTT PIERCE LLPC

Provider Business Mailing Address
First Line	:	3054 S 9TH ST STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-6250
Country	:	US
Telephone Number	:	269-743-6139
Fax Number	:	269-290-7512

Provider Business Practice Location Address
First Line	:	3054 S 9TH ST STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-6250
Country	:	US
Telephone Number	:	269-743-6139
Fax Number	:	269-290-7512

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

Provider Enumeration Date	:	04/29/2020
Last Update Date	:	04/29/2020

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