Provider Demographics
NPI:1164976460
Name:CHRISTINE CHARYTON PHD, LLC
Entity Type:Organization
Organization Name:CHRISTINE CHARYTON PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARYTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-607-3529
Mailing Address - Street 1:1500 W 3RD AVE
Mailing Address - Street 2:STE222
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2843
Mailing Address - Country:US
Mailing Address - Phone:614-607-3529
Mailing Address - Fax:740-927-2640
Practice Address - Street 1:1500 W 3RD AVE
Practice Address - Street 2:STE222
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2843
Practice Address - Country:US
Practice Address - Phone:614-607-3529
Practice Address - Fax:740-927-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty