Provider Demographics
NPI:1619115359
Name:CULHANE, CRISTINA (LCSW)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CULHANE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:408 N KENDRICK ST
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1582
Mailing Address - Country:US
Mailing Address - Phone:928-774-6364
Mailing Address - Fax:928-556-0504
Practice Address - Street 1:408 N KENDRICK ST
Practice Address - Street 2:SUITE # 3
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1582
Practice Address - Country:US
Practice Address - Phone:928-774-6364
Practice Address - Fax:928-556-0504
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-125341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical