Healthcare Provider Details

I. General information

NPI: 1083135388
Provider Name (Legal Business Name): CHRISTINA CORRINE CARMONY MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA CORRINE JOSEPH

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 07/21/2022
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 TRANSVERSE DR
TOLEDO OH
43614-8008
US

IV. Provider business mailing address

4510 DORR ST # MS 840
TOLEDO OH
43615-4040
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-5695
  • Fax: 419-383-3031
Mailing address:
  • Phone: 419-383-5695
  • Fax: 419-383-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1901141
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE.1901141
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: