Provider Demographics
NPI:1518346386
Name:DEPAOLIS, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DEPAOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:DEPAOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LMHC, CAP
Mailing Address - Street 1:5601 CORPORATE WAY STE 320
Mailing Address - Street 2:SUITE 320
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2043
Mailing Address - Country:US
Mailing Address - Phone:561-899-0930
Mailing Address - Fax:
Practice Address - Street 1:5601 CORPORATE WAY
Practice Address - Street 2:SUITE 320
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2025
Practice Address - Country:US
Practice Address - Phone:561-899-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6340101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health