Provider Demographics
NPI:1154627065
Name:ESTES, CRISTY CLARK (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:CRISTY
Middle Name:CLARK
Last Name:ESTES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25471 TEVESINE CT
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-5665
Mailing Address - Country:US
Mailing Address - Phone:941-456-0302
Mailing Address - Fax:
Practice Address - Street 1:25471 TEVESINE CT
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-5665
Practice Address - Country:US
Practice Address - Phone:941-456-0302
Practice Address - Fax:888-217-4124
Is Sole Proprietor?:No
Enumeration Date:2011-02-10
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health