Provider Demographics
NPI:1558861591
Name:LOEFFLER-AUGUSTINE, CHRISTINA L (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:LOEFFLER-AUGUSTINE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3590 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4123
Mailing Address - Country:US
Mailing Address - Phone:330-328-9879
Mailing Address - Fax:
Practice Address - Street 1:4161 BRIDGEWATER PKWY
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6191
Practice Address - Country:US
Practice Address - Phone:330-865-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700441101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)