Provider Demographics
NPI:1790902856
Name:LONGO, CHRISTA (BA)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:LONGO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34656-0428
Mailing Address - Country:US
Mailing Address - Phone:727-841-4200
Mailing Address - Fax:727-841-4365
Practice Address - Street 1:7809 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3028
Practice Address - Country:US
Practice Address - Phone:727-841-4200
Practice Address - Fax:727-841-4365
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker