Provider Demographics
NPI:1396835336
Name:MARTINO-FLEMING, CHRISTINE (LMHC, QMHP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MARTINO-FLEMING
Suffix:
Gender:F
Credentials:LMHC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1536
Mailing Address - Country:US
Mailing Address - Phone:508-369-3602
Mailing Address - Fax:
Practice Address - Street 1:66 MAIN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2777
Practice Address - Country:US
Practice Address - Phone:508-369-3602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPC198101Y00000X
MA9170101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIVF56206Medicaid