Provider Demographics
NPI:1629512496
Name:MARTIN, CHRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MARTIN
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 1:1315 W ST NW
Mailing Address - Street 2:APT. 245
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6842
Mailing Address - Country:US
Mailing Address - Phone:202-670-8864
Mailing Address - Fax:
Practice Address - Street 1:2001 MASSACHUSETTS AVE NW
Practice Address - Street 2:INGETRATIVE BEHAIVORAL SUPPORTS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1011
Practice Address - Country:US
Practice Address - Phone:202-785-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health