Provider Demographics
NPI:1255095642
Name:CHRISTY, DAVID STEWART JR (MSW, JD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:STEWART
Last Name:CHRISTY
Suffix:JR
Gender:M
Credentials:MSW, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4615
Mailing Address - Country:US
Mailing Address - Phone:202-664-2825
Mailing Address - Fax:
Practice Address - Street 1:24 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4615
Practice Address - Country:US
Practice Address - Phone:202-664-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD248871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical