Provider Demographics
NPI:1538598727
Name:CURTIS-DAVIDSON, RICO (LPC)
Entity type:Individual
Prefix:
First Name:RICO
Middle Name:
Last Name:CURTIS-DAVIDSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 W PEACHTREE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3608
Mailing Address - Country:US
Mailing Address - Phone:404-589-9040
Mailing Address - Fax:404-589-1615
Practice Address - Street 1:1117 W PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3608
Practice Address - Country:US
Practice Address - Phone:404-589-9040
Practice Address - Fax:404-589-1615
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional