Provider Demographics
NPI:1679890453
Name:CHRISTIE, CAROLINE JANE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:JANE
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:JANE
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 1347
Mailing Address - Street 2:
Mailing Address - City:GRANTHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03753-1347
Mailing Address - Country:US
Mailing Address - Phone:802-318-7635
Mailing Address - Fax:
Practice Address - Street 1:45 LYME RD STE 200
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1260
Practice Address - Country:US
Practice Address - Phone:603-932-5719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
NH29101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker