Provider Demographics
NPI:1821336348
Name:ALLEN, CHRISTINE CHERYL (MSW, LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CHERYL
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:CHERYL
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1611B OWEN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3425
Mailing Address - Country:US
Mailing Address - Phone:910-483-5884
Mailing Address - Fax:
Practice Address - Street 1:1611B OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3425
Practice Address - Country:US
Practice Address - Phone:910-483-5884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2023-08-15
Deactivation Date:2014-12-10
Deactivation Code:
Reactivation Date:2022-10-20
Provider Licenses
StateLicense IDTaxonomies
NCP0192151041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical