Provider Demographics
NPI:1306414495
Name:BELKNAP, CHRISTINA EUDORA JUNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:EUDORA JUNE
Last Name:BELKNAP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N CONGRESS AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3292
Mailing Address - Country:US
Mailing Address - Phone:856-412-8900
Mailing Address - Fax:
Practice Address - Street 1:4700 N CONGRESS AVE STE 301
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3292
Practice Address - Country:US
Practice Address - Phone:856-412-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0218881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical