Provider Demographics
NPI:1104965128
Name:DEBERARDINIS, CHRISTINE NICOLE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:DEBERARDINIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1997 ANNAPOLIS EXCHANGE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3271
Mailing Address - Country:US
Mailing Address - Phone:410-972-4529
Mailing Address - Fax:
Practice Address - Street 1:1997 ANNAPOLIS EXCHANGE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3271
Practice Address - Country:US
Practice Address - Phone:410-972-4529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical