Provider Demographics
NPI:1700364056
Name:DELGADO, CHRISTINA (LLBSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 DIANA ST
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1987
Mailing Address - Country:US
Mailing Address - Phone:231-845-6294
Mailing Address - Fax:231-845-7095
Practice Address - Street 1:105 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1112
Practice Address - Country:US
Practice Address - Phone:231-873-2108
Practice Address - Fax:231-845-7095
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802089269104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker