Provider Demographics
NPI:1932467719
Name:CALVERT, CHRISTINA MARIE
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NORTH 2ND STREET
Mailing Address - Street 2:FAMILY PRESERVATION SERVICES INC.
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34957
Mailing Address - Country:US
Mailing Address - Phone:772-595-3773
Mailing Address - Fax:
Practice Address - Street 1:1301 BELL AVE
Practice Address - Street 2:ST. LUCIE JUVENILE CENTER
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982
Practice Address - Country:US
Practice Address - Phone:772-468-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor