Provider Demographics
NPI:1447206339
Name:ROUTHIER, CHRISTINE HOPE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:HOPE
Last Name:ROUTHIER
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 1:45 HARTFORD TPKE
Mailing Address - Street 2:STE 2
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5274
Mailing Address - Country:US
Mailing Address - Phone:860-647-8995
Mailing Address - Fax:860-647-6930
Practice Address - Street 1:45 HARTFORD TPKE
Practice Address - Street 2:STE 2
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5274
Practice Address - Country:US
Practice Address - Phone:860-647-8995
Practice Address - Fax:860-647-6930
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0061261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004259455Medicaid
CT800003857Medicare ID - Type Unspecified