Provider Demographics
NPI:1013546035
Name:TWITTY, CHRISTINE ANN (LPC, MS, NCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:TWITTY
Suffix:
Gender:F
Credentials:LPC, MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 STORRS ROAD
Mailing Address - Street 2:# 291
Mailing Address - City:MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268
Mailing Address - Country:US
Mailing Address - Phone:860-415-9546
Mailing Address - Fax:860-980-6180
Practice Address - Street 1:240 PROVIDENCE NEW LON
Practice Address - Street 2:
Practice Address - City:NORTH STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06359-1724
Practice Address - Country:US
Practice Address - Phone:860-574-4570
Practice Address - Fax:860-731-5536
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional