Provider Demographics
NPI:1467631366
Name:CASTNER, CHRISTIE SUZANNE (MFT)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:SUZANNE
Last Name:CASTNER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 3RD ST S
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-4072
Mailing Address - Country:US
Mailing Address - Phone:904-853-3300
Mailing Address - Fax:904-212-2151
Practice Address - Street 1:2380 3RD ST S
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4072
Practice Address - Country:US
Practice Address - Phone:904-853-3300
Practice Address - Fax:904-212-2151
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist