Provider Demographics
NPI:1578808804
Name:DAVIN, CHRISTINE (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DAVIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BENEDICT RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1238
Mailing Address - Country:US
Mailing Address - Phone:203-518-5638
Mailing Address - Fax:
Practice Address - Street 1:7 SCHOOL ST
Practice Address - Street 2:#3B
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1855
Practice Address - Country:US
Practice Address - Phone:230-518-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist