Provider Demographics
NPI:1619593746
Name:CHRISTINE CHAFFIN COUNSELING
Entity Type:Organization
Organization Name:CHRISTINE CHAFFIN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD PARENT PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-390-3411
Mailing Address - Street 1:112 N B ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-4604
Mailing Address - Country:US
Mailing Address - Phone:850-390-3411
Mailing Address - Fax:844-950-3068
Practice Address - Street 1:112 N B ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-4604
Practice Address - Country:US
Practice Address - Phone:850-390-3411
Practice Address - Fax:844-950-3068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health