Provider Demographics
NPI:1689115180
Name:BALDWIN, CHRISTA (MSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:LANDORF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:4422 E COLUMBUS DR
Mailing Address - Street 2:DACCO
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605
Mailing Address - Country:US
Mailing Address - Phone:813-384-4000
Mailing Address - Fax:813-984-6729
Practice Address - Street 1:4422 E COLUMBUS DR
Practice Address - Street 2:DACCO
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605
Practice Address - Country:US
Practice Address - Phone:813-384-4000
Practice Address - Fax:813-984-6729
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 83171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical