Provider Demographics
NPI:1215565825
Name:HOBSON, CHRISTINA NICHOLE (CADCA1)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:NICHOLE
Last Name:HOBSON
Suffix:
Gender:F
Credentials:CADCA1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E DIXIE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1162
Mailing Address - Country:US
Mailing Address - Phone:270-505-6433
Mailing Address - Fax:270-506-3253
Practice Address - Street 1:413 E DIXIE STE 106
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-505-6433
Practice Address - Fax:270-506-3253
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36787175T00000X
KY1166980175T00000X
KY272922101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist