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General NPI Number Information
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NPI Number | 1922515055
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Entity Type | Individual
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Provider Name | CHRISTINA CHYKIRDA LPC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 150 N MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06042-2086
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Country | US
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Telephone | 860-533-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 41 CARILLON DR APT D
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City | ROCKY HILL
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State | CT
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Zip | 06067-2541
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Country | US
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Telephone | 860-490-6283
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 004112
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License Number State | CT
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