Provider Demographics
NPI:1619782463
Name:WHILES, CURTIS DALE (MED, LPCA)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:DALE
Last Name:WHILES
Suffix:
Gender:M
Credentials:MED, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 COOMER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3816
Mailing Address - Country:US
Mailing Address - Phone:606-219-3125
Mailing Address - Fax:
Practice Address - Street 1:402 COOMER ST STE 201
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3816
Practice Address - Country:US
Practice Address - Phone:606-219-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275452101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health