Provider Demographics
NPI:1790003978
Name:KANE, CHRISTINA B (LPCMH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:B
Last Name:KANE
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 FOX CHASE RD
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5511
Mailing Address - Country:US
Mailing Address - Phone:302-335-5858
Mailing Address - Fax:302-335-5858
Practice Address - Street 1:145 FOX CHASE RD
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-5511
Practice Address - Country:US
Practice Address - Phone:302-335-5858
Practice Address - Fax:302-335-5858
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC00000490101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor