Provider Demographics
NPI:1417225301
Name:CHRISTINA ARMSTRONG LCSW LLC
Entity Type:Organization
Organization Name:CHRISTINA ARMSTRONG LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-309-8193
Mailing Address - Street 1:85 GOLF CREST DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2698
Mailing Address - Country:US
Mailing Address - Phone:770-309-8193
Mailing Address - Fax:770-974-2060
Practice Address - Street 1:85 GOLF CREST DR
Practice Address - Street 2:SUITE 309
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2698
Practice Address - Country:US
Practice Address - Phone:770-309-8193
Practice Address - Fax:770-974-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0029701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA220502325AMedicaid