Provider Demographics
NPI:1043387970
Name:SLAGLE, CHRISTINE LYNNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LYNNE
Last Name:SLAGLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 EAST 20TH STREET
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5412
Mailing Address - Country:US
Mailing Address - Phone:562-599-9271
Mailing Address - Fax:562-218-4103
Practice Address - Street 1:240 EAST 20TH STREET
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5412
Practice Address - Country:US
Practice Address - Phone:562-599-9271
Practice Address - Fax:562-218-4103
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical