Provider Demographics
NPI:1760984447
Name:HAINES, CHRISTINE T (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:T
Last Name:HAINES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13850 FIR TREE LN
Mailing Address - Street 2:
Mailing Address - City:CRESAPTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5959
Mailing Address - Country:US
Mailing Address - Phone:301-697-4975
Mailing Address - Fax:
Practice Address - Street 1:907 SETON DRIVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-777-0633
Practice Address - Fax:240-362-7110
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19175106H00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist