Provider Demographics
NPI:1770188401
Name:KIRKLAND, CHRISTINA SUE (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SUE
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:SUE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 JUDY SMITH DR
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-4501
Mailing Address - Country:US
Mailing Address - Phone:205-451-7367
Mailing Address - Fax:
Practice Address - Street 1:JASPER CBOC
Practice Address - Street 2:1454 JONES DAIRY RD
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-221-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical