Provider Demographics
NPI:1366846958
Name:HERNANDEZ, CHRISTINE (LPGC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LPGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 MONTGOMERY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4409
Mailing Address - Country:US
Mailing Address - Phone:888-715-1120
Mailing Address - Fax:
Practice Address - Street 1:4424 MONTGOMERY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4409
Practice Address - Country:US
Practice Address - Phone:888-715-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18325101Y00000X, 101YM0800X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool