Provider Demographics
NPI:1508515081
Name:STANLEY, CHRISTINA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S WESTGATE DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1640
Mailing Address - Country:US
Mailing Address - Phone:336-915-2238
Mailing Address - Fax:
Practice Address - Street 1:300 S WESTGATE DR STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1640
Practice Address - Country:US
Practice Address - Phone:336-907-7308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA17446OtherNC BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS