Provider Demographics
NPI:1659423739
Name:SMITH, CHRISTINE C (LCPC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:C
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:331 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6308
Mailing Address - Country:US
Mailing Address - Phone:207-344-6290
Mailing Address - Fax:207-344-6177
Practice Address - Street 1:331 PINE ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6308
Practice Address - Country:US
Practice Address - Phone:207-344-6290
Practice Address - Fax:207-344-6177
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC19601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical