Provider Demographics
NPI:1710252960
Name:CHRISTI, BERNADETTE AGNES (LPC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:AGNES
Last Name:CHRISTI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 SAM NEWELL RD
Mailing Address - Street 2:112
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5015
Mailing Address - Country:US
Mailing Address - Phone:980-200-3040
Mailing Address - Fax:
Practice Address - Street 1:1122 SAM NEWELL RD
Practice Address - Street 2:112
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5015
Practice Address - Country:US
Practice Address - Phone:980-224-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8556101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional