Provider Demographics
NPI:1659307940
Name:MCGURGAN, CHRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MCGURGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:MCGURGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:510 S INDEPENDENCE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1155
Mailing Address - Country:US
Mailing Address - Phone:757-447-2859
Mailing Address - Fax:
Practice Address - Street 1:510 S INDEPENDENCE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1155
Practice Address - Country:US
Practice Address - Phone:757-447-2859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1628101YP2500X
VA0701004861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG934-0004OtherNCA CAREFIRST BCBS
MD405752000Medicaid
MD621708-03OtherMD CAREFIRST BCBS
MD587926-000OtherMAGELLAN
MDPK100072973OtherAPS
MD7334493OtherAETNA
MD3117718OtherMAMSI