Provider Demographics
NPI:1477520773
Name:PONGRATZ, CHRISTINE R (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:R
Last Name:PONGRATZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IM BERG 10
Mailing Address - Street 2:
Mailing Address - City:RIPPENWEIER
Mailing Address - State:BADEN WURTEMBURG
Mailing Address - Zip Code:69469
Mailing Address - Country:DE
Mailing Address - Phone:0621-730-3118
Mailing Address - Fax:
Practice Address - Street 1:CMR 437
Practice Address - Street 2:BOX 1422
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09267
Practice Address - Country:DE
Practice Address - Phone:0621-730-3118
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical