Healthcare Provider Details

I. General information

NPI: 1801348909
Provider Name (Legal Business Name): CHRISTINA LORI SEBRING LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA LORI SEBRING LSW

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 MARKET ST 8440 MARKET ST.
BOARDMAN OH
44512-6702
US

IV. Provider business mailing address

8440 MARKET ST
BOARDMAN OH
44512-6702
US

V. Phone/Fax

Practice location:
  • Phone: 330-286-0050
  • Fax: 330-286-0050
Mailing address:
  • Phone: 330-286-0050
  • Fax: 330-286-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS29246
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: