Provider Demographics
NPI:1215007158
Name:WOODS, CHRISTINA MICHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11026 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-7907
Mailing Address - Country:US
Mailing Address - Phone:573-368-8595
Mailing Address - Fax:573-368-2746
Practice Address - Street 1:11026 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-7907
Practice Address - Country:US
Practice Address - Phone:573-368-8595
Practice Address - Fax:573-368-2746
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001022084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO495355703Medicaid