Provider Demographics
NPI:1396212916
Name:ALTON, CHRISTINA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ALTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CHRISITNA
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:299 FORT HOYLE RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-4805
Mailing Address - Country:US
Mailing Address - Phone:410-612-1525
Mailing Address - Fax:
Practice Address - Street 1:299 FORT HOYLE RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-4805
Practice Address - Country:US
Practice Address - Phone:410-612-1525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD092611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical