Provider Demographics
NPI:1801036009
Name:SMITH, CHRISTINE SARI (CSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:SARI
Last Name:SMITH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 POTTER ST
Mailing Address - Street 2:#1
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2621
Mailing Address - Country:US
Mailing Address - Phone:608-434-1337
Mailing Address - Fax:
Practice Address - Street 1:800 POTTER ST
Practice Address - Street 2:#1
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2621
Practice Address - Country:US
Practice Address - Phone:608-434-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7507-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker