Provider Demographics
NPI:1275046393
Name:FINGERLE, CHRISTINA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:FINGERLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4457 POPPS FERRY RD LOT 138
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-2386
Mailing Address - Country:US
Mailing Address - Phone:228-697-8446
Mailing Address - Fax:
Practice Address - Street 1:15094 COUNTY BARN RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4200
Practice Address - Country:US
Practice Address - Phone:228-868-6524
Practice Address - Fax:228-863-0096
Is Sole Proprietor?:No
Enumeration Date:2017-11-11
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM9170104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker