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General NPI Number Information
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NPI Number | 1619966397
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Entity Type | Individual
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Provider Name | CHRISTINA C CHRISTIE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 131 FRANKLIN HEALTH CMNS STE A
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City | FARMINGTON
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State | ME
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Zip | 04938-6142
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Country | US
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Telephone | 207-778-0035
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Fax | 207-778-6879
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Provider Business Mailing Address
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Address Line | 131 FRANKLIN HEALTH CMNS STE A
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City | FARMINGTON
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State | ME
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Zip | 04938-6142
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Country | US
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Telephone | 207-778-0035
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Fax | 207-778-6879
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAC3231
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MC9951
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License Number State | ME
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