Provider Demographics
NPI:1780050732
Name:EDWARDS, CHRISTINE ANN (LMHC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CHRISITNE
Other - Middle Name:ANN
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:11547 BAY GARDENS LOOP
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2032
Mailing Address - Country:US
Mailing Address - Phone:727-744-0914
Mailing Address - Fax:
Practice Address - Street 1:11547 BAY GARDENS LOOP
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2032
Practice Address - Country:US
Practice Address - Phone:727-744-0914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor