Provider Demographics
NPI:1154627255
Name:PACHOLIK, CHRISTINA M (COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:M
Last Name:PACHOLIK
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LAKE VISTA TRL APT 206
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6353
Mailing Address - Country:US
Mailing Address - Phone:772-579-6106
Mailing Address - Fax:
Practice Address - Street 1:512 SW PT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953
Practice Address - Country:US
Practice Address - Phone:772-873-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health