Provider Demographics
NPI:1003102492
Name:GIORGIO-CAHALAN, CHRISTINE MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:GIORGIO-CAHALAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:GIORGIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2435 KIMBERLY RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3509
Mailing Address - Country:US
Mailing Address - Phone:563-355-0780
Mailing Address - Fax:563-355-0656
Practice Address - Street 1:2435 KIMBERLY RD
Practice Address - Street 2:SUITE 145
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3509
Practice Address - Country:US
Practice Address - Phone:563-355-0780
Practice Address - Fax:563-355-0656
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000346106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA600724149Medicaid