Provider Demographics
NPI:1548992092
Name:CURTISS, SHANNEL (LCSW)
Entity type:Individual
Prefix:
First Name:SHANNEL
Middle Name:
Last Name:CURTISS
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 1:2424 COVE RD
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-8795
Mailing Address - Country:US
Mailing Address - Phone:757-902-3404
Mailing Address - Fax:
Practice Address - Street 1:12550 BISCAYNE BLVD STE 212
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2501
Practice Address - Country:US
Practice Address - Phone:786-906-8656
Practice Address - Fax:786-761-7569
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060122901041C0700X
FLSW237701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical