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General NPI Number Information
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NPI Number | 1548935505
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Entity Type | Individual
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Provider Name | CHRISTINA NICHOLE FIELDS LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 170 JENNIFER RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3064
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Country | US
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Telephone | 443-291-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 5113 APPLEGATE DR
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City | FORT WORTH
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State | TX
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Zip | 76119-7012
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Country | US
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Telephone | 903-375-1683
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 104906
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 27783
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License Number State | MD
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