Provider Demographics
NPI:1881191492
Name:BLEIMEYER, CHRISTINA (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BLEIMEYER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-3036
Mailing Address - Country:US
Mailing Address - Phone:617-439-9900
Mailing Address - Fax:617-439-9990
Practice Address - Street 1:200 HIGH ST FL 7
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3036
Practice Address - Country:US
Practice Address - Phone:617-439-9900
Practice Address - Fax:617-439-9990
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1197131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical