Provider Demographics
NPI:1144898040
Name:CURTIS, KELSEY AMANDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:AMANDA
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 MILE GATE LN
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-2638
Mailing Address - Country:US
Mailing Address - Phone:804-832-1015
Mailing Address - Fax:
Practice Address - Street 1:921 CAPITOL LANDING RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-4348
Practice Address - Country:US
Practice Address - Phone:757-253-4074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040128531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical