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General NPI Number Information
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NPI Number | 1336687680
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Entity Type | Individual
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Provider Name | CHRISTINA JEAN LERCH MA, NCC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 18245 PAULSON DR UNIT 116
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-1019
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Country | US
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Telephone | 941-276-5229
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Fax | 941-629-0237
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Provider Business Mailing Address
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Address Line | 2719 N CHAMBERLAIN BLVD
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City | NORTH PORT
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State | FL
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Zip | 34286-9308
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Country | US
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Telephone | 941-276-5229
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Fax | 941-629-0237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MH14732
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License Number State | FL
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