Provider Demographics
NPI:1912697343
Name:MENDEZ, CHRISTINA BELINDA (LADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:BELINDA
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WOOSTER ST UNIT 7B
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-3152
Mailing Address - Country:US
Mailing Address - Phone:203-685-0280
Mailing Address - Fax:
Practice Address - Street 1:111 WOOSTER ST UNIT 7B
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-3152
Practice Address - Country:US
Practice Address - Phone:203-685-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1497101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)