Provider Demographics
NPI:1538432612
Name:CURLEY, GERALD IAN (LMSW)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:IAN
Last Name:CURLEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:G,
Other - Middle Name:IAN
Other - Last Name:FISHER-CURLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:570 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-2334
Mailing Address - Country:US
Mailing Address - Phone:313-875-7121
Mailing Address - Fax:
Practice Address - Street 1:570 CLINTON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-2334
Practice Address - Country:US
Practice Address - Phone:313-875-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010717171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical