Provider Demographics
NPI:1467523845
Name:SAMYAN, CHRISTINA MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:SAMYAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ROCKFORD RD
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-2446
Mailing Address - Country:US
Mailing Address - Phone:610-457-6822
Mailing Address - Fax:
Practice Address - Street 1:210 W FRONT ST
Practice Address - Street 2:2CD FL, SUITE 3
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3101
Practice Address - Country:US
Practice Address - Phone:610-565-6067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0156031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical