Provider Demographics
NPI:1124179981
Name:CHRISTIANA COUNSELING AND PSYCHIATRIC ASSOCIATES INC.
Entity Type:Organization
Organization Name:CHRISTIANA COUNSELING AND PSYCHIATRIC ASSOCIATES INC.
Other - Org Name:CHRISTIANA COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, LICENCED CLINICAL SOCIAL WOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-995-1680
Mailing Address - Street 1:5235 W WOODMILL DR
Mailing Address - Street 2:SUITES 47 & 48
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4068
Mailing Address - Country:US
Mailing Address - Phone:302-995-1680
Mailing Address - Fax:302-995-1790
Practice Address - Street 1:5235 W WOODMILL DR
Practice Address - Street 2:SUITES 47 & 48
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-995-1680
Practice Address - Fax:302-995-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1996107299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG00189Medicare ID - Type UnspecifiedGROUP NUMBER FOR PRACTICE