Provider Demographics
NPI:1619757523
Name:MALU, CHRISTINA YVONNE (LCSW, LCAS-A)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:YVONNE
Last Name:MALU
Suffix:
Gender:F
Credentials:LCSW, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 DECATUR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-6828
Mailing Address - Country:US
Mailing Address - Phone:910-381-8438
Mailing Address - Fax:
Practice Address - Street 1:900 DENNIS RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7287
Practice Address - Country:US
Practice Address - Phone:910-381-8438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCO13364101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health