Provider Demographics
NPI:1932129517
Name:BALLENGER, CHRISTINE ASHLEY (PSYD, LPC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ASHLEY
Last Name:BALLENGER
Suffix:
Gender:F
Credentials:PSYD, LPC
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:ASHLEY
Other - Last Name:KISTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, LPC
Mailing Address - Street 1:106 CHESTER STREET
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3323
Mailing Address - Country:US
Mailing Address - Phone:540-252-2654
Mailing Address - Fax:855-529-4516
Practice Address - Street 1:106 CHESTER STREET
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3323
Practice Address - Country:US
Practice Address - Phone:540-252-2654
Practice Address - Fax:855-529-4516
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005807103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKPHS0000Medicare UPIN
OK1201485Medicaid