Provider Demographics
NPI:1235643727
Name:GHALY, CHRISTINE (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:GHALY
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BAYSHORE BLVD
Mailing Address - Street 2:605
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2344
Mailing Address - Country:US
Mailing Address - Phone:908-310-7813
Mailing Address - Fax:
Practice Address - Street 1:345 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2344
Practice Address - Country:US
Practice Address - Phone:908-310-7813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00534700101YP2500X
FLMH13529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional