Provider Demographics
NPI:1902206550
Name:WEBSTER, CHRISTINA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 PENDER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-0989
Mailing Address - Country:US
Mailing Address - Phone:703-865-8686
Mailing Address - Fax:703-865-6506
Practice Address - Street 1:3930 PENDER DR STE 350
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-0989
Practice Address - Country:US
Practice Address - Phone:703-865-8686
Practice Address - Fax:703-865-6506
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087117101Y00000X
VA0904010734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor