Provider Demographics
NPI:1629846696
Name:DENICOLA, CHRISTINA ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROSE
Last Name:DENICOLA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ROSE
Other - Last Name:SILVESTRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:12008 S SHORE BLVD STE 107-1
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6395
Mailing Address - Country:US
Mailing Address - Phone:203-305-0009
Mailing Address - Fax:
Practice Address - Street 1:12008 S SHORE BLVD STE 107-1
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6395
Practice Address - Country:US
Practice Address - Phone:203-305-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21672101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health